Provider Demographics
NPI:1417620014
Name:PIEPHO, NANCY JUNE (MA, CHW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JUNE
Last Name:PIEPHO
Suffix:
Gender:F
Credentials:MA, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-4700
Mailing Address - Country:US
Mailing Address - Phone:507-444-7683
Mailing Address - Fax:
Practice Address - Street 1:635 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-4700
Practice Address - Country:US
Practice Address - Phone:507-444-7683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker