Provider Demographics
NPI:1154133528
Name:PEPITONE, JOSEPH MICHAEL
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:PEPITONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:MICHAEL
Other - Last Name:PEPITONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9290 W DODGE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3320
Mailing Address - Country:US
Mailing Address - Phone:402-393-0833
Mailing Address - Fax:402-501-7191
Practice Address - Street 1:9290 W DODGE RD STE 201
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3320
Practice Address - Country:US
Practice Address - Phone:402-393-0833
Practice Address - Fax:402-502-7191
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider