Provider Demographics
NPI:1558759407
Name:KLOEPPING, KARRI (PA)
Entity Type:Individual
Prefix:
First Name:KARRI
Middle Name:
Last Name:KLOEPPING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E MILLER RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-1252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:106 E MARKET ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARROLL
Practice Address - State:IL
Practice Address - Zip Code:61053-1108
Practice Address - Country:US
Practice Address - Phone:815-244-3678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085005267363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant