Provider Demographics
NPI:1407271448
Name:NEPPL, RENITA
Entity type:Individual
Prefix:
First Name:RENITA
Middle Name:
Last Name:NEPPL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 S BAY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5062
Mailing Address - Country:US
Mailing Address - Phone:701-235-6699
Mailing Address - Fax:701-235-3758
Practice Address - Street 1:2626 S BAY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5062
Practice Address - Country:US
Practice Address - Phone:701-235-6699
Practice Address - Fax:701-235-3758
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)