| Doctor Name: | MS. NICOLE MARIE KOEPKE |
| NPI Number: | 1003006735 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP007292 |
| Business Practice Address: | 3401 Civic Center Blvd Children's Hospital Of Philadelphia - Emergency Med Philadelphia, PA - 191044319 |
| Business Phone Number: | 2155901944 |
| Business Fax Number: | 2155904454 |
| Mailing Address: | 100 E Penn Sq, 9th Floor PHILADELPHIA |
| State: | PA |
| Postal Code: | 191073323 |
| Phone Number: | 2674259234 |
| Fax Number: | 2674259299 |
| NPI Enumeration Date: | 07/30/2007 |
| NPI Last Update Date: | 05/30/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | SP007292 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |