Healthcare Provider Details

I. General information

NPI: 1194708065
Provider Name (Legal Business Name): PAMELA PIEPER MSN, PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 11/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S NEWELL DRIVE
GAINESVILLE FL
32611
US

IV. Provider business mailing address

PO BOX 100197
GAINESVILLE FL
32610-0197
US

V. Phone/Fax

Practice location:
  • Phone: 904-244-3913
  • Fax: 904-244-3870
Mailing address:
  • Phone: 904-244-3913
  • Fax: 904-244-3870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1589572
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: