Provider Demographics
NPI:1932127966
Name:WEPPLER, MARY P (ANP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:P
Last Name:WEPPLER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2841 DEBARR RD
Mailing Address - Street 2:SUITE 43
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-274-7847
Mailing Address - Fax:907-274-7845
Practice Address - Street 1:2841 DEBARR RD
Practice Address - Street 2:SUITE 43
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-274-7847
Practice Address - Fax:907-274-7845
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK738363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK500028970OtherRAILROAD MEDICARE
AKNP93731Medicaid
AKK152401Medicare PIN
AKNP93731Medicaid