Provider Demographics
NPI:1558126813
Name:PEPPLER, ABBRIEL (NP)
Entity Type:Individual
Prefix:MRS
First Name:ABBRIEL
Middle Name:
Last Name:PEPPLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:
Other - Last Name:PEPPLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:660 MASON RIDGE CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8512
Mailing Address - Country:US
Mailing Address - Phone:314-448-3791
Mailing Address - Fax:314-996-7658
Practice Address - Street 1:1501 PROFESSIONAL DR STE 300
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:MO
Practice Address - Zip Code:63052-3809
Practice Address - Country:US
Practice Address - Phone:314-953-6801
Practice Address - Fax:314-953-8272
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024005888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily