Individual
LEVI JEPPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
320 WARNER DR, LEWISTON, ID 83501-4441
(208) 743-3523
Mailing address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
7661573
ID
Other
Enumeration date
07/19/2023
Last updated
12/10/2024
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