MEDICARE: DANIEL W ZEPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	SP026938	PA

General Provider Information

NPI Number	:	1871209759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL W ZEPP

Provider Business Mailing Address
First Line	:	640 FISH AND GAME RD
Second Line	:
City	:	EAST BERLIN
State	:	PA
Zip	:	17316-9431
Country	:	US
Telephone Number	:	717-850-5674
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 FISH AND GAME RD
Second Line	:
City	:	EAST BERLIN
State	:	PA
Zip	:	17316-9431
Country	:	US
Telephone Number	:	717-850-5674
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	01/25/2023

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