Brooke Walter Pieper, A.P.R.N.
Individual provider Active NPI Primary Care Nurse Practitioner · Panguitch, UT
NPI 1295570059 · NPPES record last updated Jun 25, 2024
Key facts
- NPI
- 1295570059
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 5138621-4405 (UT)
- Practice address
- 948 S. 190 E.
Panguitch, UT 84759-1235 - Phone
- (435) 690-0237
- NPI assigned
- Jun 25, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240814000774 | UT | Practitioner - Nurse Practitioner | 7517405194 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5138621-4405 | UT | MD | Primary Care Nurse Practitioner |
Interoperability endpoints
- brooke.pieper.1@20544.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 5138621-4405 | UT | Yes |
Addresses
Primary practice location
948 S. 190 E.
Panguitch, UT 84759-1235
Mailing address
308 E 4500 S Ste B
Murray, UT 84107-3957
Phone (801) 900-3280
Other providers in Panguitch, UT
- Timothy James Marshall
- Todd Stanley Mooney
- Panguitch Drug Corp
- Bryant Pearson
- Melinda Lee Peterson
- Prevent Inc.
- Carole A Ray
- Shaunna Michele Rechsteiner
- Alec Reynolds
- Robert L Smith DC PC
All providers in Panguitch, UT · Primary Care Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.