Provider Demographics
NPI:1134125594
Name:KOEPPING, MARGARET JULIE (RN-BC, MN, FNP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:JULIE
Last Name:KOEPPING
Suffix:
Gender:F
Credentials:RN-BC, MN, FNP
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 357
Mailing Address - Street 2:
Mailing Address - City:WELLPINIT
Mailing Address - State:WA
Mailing Address - Zip Code:99040-0357
Mailing Address - Country:US
Mailing Address - Phone:509-258-4517
Mailing Address - Fax:509-258-6757
Practice Address - Street 1:6203 AGENCY LOOP ROAD
Practice Address - Street 2:
Practice Address - City:WELLPINIT
Practice Address - State:WA
Practice Address - Zip Code:99040-0357
Practice Address - Country:US
Practice Address - Phone:509-258-4517
Practice Address - Fax:509-258-6757
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00089058163W00000X
WAAP30004280363LF0000X
OR200150019NP FNP PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2003298Medicaid
WA8HK219Medicare PIN