Provider Demographics
NPI:1306668082
Name:HUEPPCHEN, JASON (RN)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HUEPPCHEN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3480 TABITHA CT
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-8717
Mailing Address - Country:US
Mailing Address - Phone:262-573-1692
Mailing Address - Fax:
Practice Address - Street 1:3480 TABITHA CT
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-8717
Practice Address - Country:US
Practice Address - Phone:262-573-1692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9466973163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse