Mary Anne Koeppel, A.R.N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

ARNP 523132 Issued in FL

Practice address

1881 Professional Park Cir
Suite 80
Tallahassee, FL 32308-4541

Phone

(850) 402-5454

Fax

(850) 402-5451

NPI assigned

Dec 29, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Mary Anne Grim Koeppel Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Professional Park Pediatrics P.a.

  • Pediatrics Physician
  • Tallahassee, FL
  • NPI 1841289204
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164409306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7047 DARDWOOD LN",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323123511",
            "telephone_number": "850-893-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 PROFESSIONAL PARK CIR",
            "address_2": "SUITE 80",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084541",
            "telephone_number": "850-402-5454",
            "fax_number": "850-402-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPPEL",
        "first_name": "MARY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP 523132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANNE",
            "last_name": "KOEPPEL",
            "middle_name": "GRIM",
            "prefix": "MRS.",
            "credential": "A.R.N.P.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Sydney S Knutson, RBT
• Fang Sarah Ko, MD
• Jaroslaw Lucas Koberda, M.D., PHD, NEUROLOGY
• Brandi Shanell Koch, RNFA
• Anna Thomas Koeppel, MD
• Michael J. Kofler, PH.D.
• Hari K. Kolli, M.B.B.S. (M.D.)
• Emily Komarczyk, MD
• Opeyemi Komolafe, PHARM .D.
• Amulya Konda, M.D.

• Pediatric Nurse Practitioner in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.