Provider Demographics
NPI:1346293859
Name:PIEPER, LAURA H (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:H
Last Name:PIEPER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:H
Other - Last Name:HERMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP
Mailing Address - Street 1:12639 OLD TESSON RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2786
Mailing Address - Country:US
Mailing Address - Phone:314-849-0311
Mailing Address - Fax:314-849-4423
Practice Address - Street 1:10777 SUNSET OFFICE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1019
Practice Address - Country:US
Practice Address - Phone:314-842-4802
Practice Address - Fax:314-849-8721
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO132032363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO078012295Medicare ID - Type Unspecified
MOS90278Medicare UPIN