Basic Information
| Provider Information | |||||||||
| NPI: | 1881060416 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEPPNER | ||||||||
| FirstName: | PEGGY | ||||||||
| MiddleName: | ELAINE | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5435 FELTL RD | ||||||||
| Address2: | |||||||||
| City: | MINNETONKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553437983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9528359880 | ||||||||
| FaxNumber: | 9528571554 | ||||||||
| Practice Location | |||||||||
| Address1: | 5435 FELTL RD | ||||||||
| Address2: | |||||||||
| City: | MINNETONKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553437983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9528359880 | ||||||||
| FaxNumber: | 9528571554 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2015 | ||||||||
| LastUpdateDate: | 08/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R 108625-6 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.