Provider Demographics
NPI:1316314420
Name:KOEPKE, BILLI JO (RNFA, FNP-C)
Entity type:Individual
Prefix:
First Name:BILLI JO
Middle Name:
Last Name:KOEPKE
Suffix:
Gender:F
Credentials:RNFA, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6422 E SPEEDWAY BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1149
Mailing Address - Country:US
Mailing Address - Phone:520-318-3004
Mailing Address - Fax:520-318-3061
Practice Address - Street 1:6422 E SPEEDWAY BLVD STE 150
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1149
Practice Address - Country:US
Practice Address - Phone:520-318-3004
Practice Address - Fax:520-318-3061
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7873363LF0000X, 163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily