Provider Demographics
NPI:1710227129
Name:PEPLINSKI, THERESA MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:MARIE
Last Name:PEPLINSKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 E BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8344
Mailing Address - Country:US
Mailing Address - Phone:541-789-5008
Mailing Address - Fax:541-789-5655
Practice Address - Street 1:2630 E BARNETT RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8344
Practice Address - Country:US
Practice Address - Phone:541-789-5008
Practice Address - Fax:541-789-5655
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201350034NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR227698Medicaid