Provider Demographics
NPI:1306628987
Name:JEPSEN, ANDREW DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DAVID
Last Name:JEPSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3960 RADIO RD STE 110
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-3741
Mailing Address - Country:US
Mailing Address - Phone:239-465-0656
Mailing Address - Fax:
Practice Address - Street 1:3960 RADIO RD STE 110
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-3741
Practice Address - Country:US
Practice Address - Phone:239-465-0656
Practice Address - Fax:239-465-0656
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14972111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor