Peppersack, Deo M

Peppersack, Deo M is an individual health care provider with primary practice located at 217 W Georgia Ave Ste 120 , Nampa ID 83686-6812. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Peppersack, Deo M can be contacted via phone (208) 498-1760.

Contact Information

Primary practice address
217 W Georgia Ave Ste 120 Nampa ID 83686-6812
Phone: (208) 498-1760
Fax: (208) 498-1761
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X NP656A Idaho
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP656A Idaho
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X NP656A Idaho

Profile Details

NPI number 1770538811
LBN Legal business name Peppersack, Deo M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Mar 18th, 2016 - about 8 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 1770538811 NPPES
Idaho MEDICAID 8083269
Idaho MEDICAID 806976700
Idaho Other NP191

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