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General NPI Number Information
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NPI Number | 1760703136
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Entity Type | Individual
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Provider Name | DENISE MARIE REPPENHAGEN NP
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Gender | Female
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 5055 AVENIDA ENCINAS STE 100
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City | CARLSBAD
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State | CA
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Zip | 92008-4375
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Country | US
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Telephone | 760-448-4412
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Fax |
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Provider Business Mailing Address
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Address Line | 1955 CITRACADO PKWY STE 203
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City | ESCONDIDO
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State | CA
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Zip | 92029-4112
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Country | US
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Telephone | 760-448-4412
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Fax | 760-918-9006
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 19213
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License Number State | CA
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