Provider Demographics
NPI:1063778934
Name:PEPPER, KRISTIE MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:MARIE
Last Name:PEPPER
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:500 UNIVERSITY DR MC CA410
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:717-531-5208
Mailing Address - Fax:717-531-0119
Practice Address - Street 1:3100 SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:PA
Practice Address - Zip Code:17057-3548
Practice Address - Country:US
Practice Address - Phone:717-948-5180
Practice Address - Fax:717-948-0488
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2024-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA27494607207R00000X
MA272127207RR0500X
PAOS021348207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine