Provider Demographics
NPI:1083002976
Name:PEPER, EMELITA ORTEGA (NP)
Entity Type:Individual
Prefix:MRS
First Name:EMELITA
Middle Name:ORTEGA
Last Name:PEPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:EMELITA
Other - Middle Name:ORTEGA
Other - Last Name:PEPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:562 VILLE PONTEAUX LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-6428
Mailing Address - Country:US
Mailing Address - Phone:631-742-6996
Mailing Address - Fax:
Practice Address - Street 1:562 VILLE PONTEAUX LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-6428
Practice Address - Country:US
Practice Address - Phone:631-742-6996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-31
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024179134363LA2200X
NY670608-1163W00000X
VA0001286425163W00000X
NYF309443363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse