Healthcare Provider Details

I. General information

NPI: 1366914053
Provider Name (Legal Business Name): TOBIAS BEPLER DNP, RN, AGPCNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 05/23/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5737 PINE RDG
HASLETT MI
48840-8946
US

IV. Provider business mailing address

5737 PINE RDG
HASLETT MI
48840-8946
US

V. Phone/Fax

Practice location:
  • Phone: 517-242-2241
  • Fax:
Mailing address:
  • Phone: 517-242-2241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704363769
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: