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General NPI Number Information
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NPI Number | 1558856310
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Entity Type | Individual
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Provider Name | STEFANIE PEPPER
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Gender | Female
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 1071 WEST BEACON ST.
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City | PHILADELPHIA
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State | MS
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Zip | 38350
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Country | US
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Telephone | 769-200-0730
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Fax | 769-200-0731
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Provider Business Mailing Address
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Address Line | PO BOX 1258
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City | WAYNESBORO
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State | TN
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Zip | 38485-1258
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Country | US
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Telephone | 931-253-1110
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Fax | 931-722-9919
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 902716
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License Number State | MS
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