Provider Demographics
NPI:1043242183
Name:EPPLE, JULIE M (RN, BC, FNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:EPPLE
Suffix:
Gender:F
Credentials:RN, BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 CALVARY CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4125
Mailing Address - Country:US
Mailing Address - Phone:636-933-2900
Mailing Address - Fax:636-933-2998
Practice Address - Street 1:1500 CALVARY CHURCH RD
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4125
Practice Address - Country:US
Practice Address - Phone:636-933-2900
Practice Address - Fax:636-933-2998
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO123926163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO425861606Medicaid
MOP01280985OtherRAILROAD MEDICARE
MO1043242183Medicaid
MO425861606Medicaid
MO152800185Medicare PIN