| Doctor Name: | MR. OWEN JOSEPH PRIEPKE |
| NPI Number: | 1417115312 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.N., B.S.N. |
| License Number: | 131601-030 |
| Business Practice Address: | 526 Mill St Campbellsport, WI - 530103502 |
| Business Phone Number: | 9205331100 |
| Business Fax Number: | 9205331148 |
| Mailing Address: | 526 Mill St, CAMPBELLSPORT |
| State: | WI |
| Postal Code: | 530103502 |
| Phone Number: | 9205331100 |
| Fax Number: | 9205331148 |
| NPI Enumeration Date: | 05/28/2008 |
| NPI Last Update Date: | 05/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0600X |
| License Number: | 131601-030 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |