Individual
LORA LEE E KOEPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
20000365
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12-01355
MEDICA
MN
01
—
40D83KO
BLUE CROSS BLUE SHIELD
MN
05
—
887019500
—
MN
Enumeration date
06/07/2006
Last updated
11/28/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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