Koepp, Mark Edwin

Koepp, Mark Edwin is an individual health care provider with primary practice located at 15790 Paul Vega Md Dr , Hammond LA 70403-1434. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Koepp, Mark Edwin can be contacted via phone (985) 230-6685.

Contact Information

Primary practice address
15790 Paul Vega Md Dr Hammond LA 70403-1434
Phone: (985) 230-6685
Fax: (985) 230-2173
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP03823 Louisiana

Profile Details

NPI number 1023072337
LBN Legal business name Koepp, Mark Edwin
Credentials RN, CRNA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated Apr 28th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023072337 NPPES
Other 430072262 RR MEDICARE#
MEDICAID 1105490 RR MEDICARE#

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