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General NPI Number Information
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NPI Number | 1295570059
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Entity Type | Individual
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Provider Name | BROOKE WALTER PIEPER A.P.R.N.
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Gender | Female
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Dates
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Enumeration Date | 06/25/2024
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 948 S. 190 E.
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City | PANGUITCH
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State | UT
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Zip | 84759-1235
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Country | US
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Telephone | 435-690-0237
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Fax |
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Provider Business Mailing Address
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Address Line | 308 E 4500 S STE B
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City | MURRAY
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State | UT
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Zip | 84107-3957
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Country | US
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Telephone | 801-900-3280
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 5138621-4405
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License Number State | UT
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