Doctor Name: | MRS. JAMIE LYNN PEPPLER |
NPI Number: | 1003057027 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 28159253A |
Business Practice Address: | 5910 Homestead Rd Fort Wayne, IN - 468144202 |
Business Phone Number: | 2604353272 |
Business Fax Number: | 2604353275 |
Mailing Address: | 5910 Homestead Rd, FORT WAYNE |
State: | IN |
Postal Code: | 468144202 |
Phone Number: | 2604353272 |
Fax Number: | 2604353275 |
NPI Enumeration Date: | 03/21/2009 |
NPI Last Update Date: | 09/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 28159253A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |