Healthcare Provider Details

I. General information

NPI: 1235486713
Provider Name (Legal Business Name): ANN PEPPERS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 08/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 JACKSON AVE
TACOMA WA
98431-1100
US

IV. Provider business mailing address

9040 JACKSON AVE
TACOMA WA
98431-1100
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-2252
  • Fax: 253-968-3278
Mailing address:
  • Phone: 253-968-2252
  • Fax: 253-968-3278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAP60292018
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: