Provider Demographics
NPI:1093280075
Name:KEPPLER, LAUREN (NMD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:KEPPLER
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 422
Mailing Address - Street 2:
Mailing Address - City:KETCHUM
Mailing Address - State:ID
Mailing Address - Zip Code:83340-0418
Mailing Address - Country:US
Mailing Address - Phone:208-721-5603
Mailing Address - Fax:208-471-4106
Practice Address - Street 1:128 SADDLE RD SUITE 103-A
Practice Address - Street 2:
Practice Address - City:KETCHUM
Practice Address - State:ID
Practice Address - Zip Code:83340
Practice Address - Country:US
Practice Address - Phone:208-721-5603
Practice Address - Fax:208-471-4106
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID0060175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath