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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

DEO M PEPPERSACK, NP
217 W GEORGIA AVE STE 120
NAMPA, ID83686-6812
 Phone: 208-498-1760
 Fax: 208-498-1761
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for DEO M PEPPERSACK · (Female)

NPI Number 1770538811
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 05/24/2006
Last updated 03/18/2016 - About 6 months ago
Sole proprietor 1 No
Identifiers
ID License # NP656A
ID Medicaid 806976700
ID Medicaid 8083269
ID Medicare UPIN Q26365
ID Other NP191 BLUE CROSS
Hospital affiliation(s)
  • SAINT ALPHONSUS MEDICAL CENTER - NAMPA - (Acute Care)
    1512 TWELFTH AVENUE ROAD
    NAMPA, ID 83686
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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