Provider Demographics
NPI:1487969739
Name:LEPKE, JOANN (APRN)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:LEPKE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41E LIPOA ST 21
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8148
Mailing Address - Country:US
Mailing Address - Phone:808-875-0511
Mailing Address - Fax:808-875-8595
Practice Address - Street 1:41 E LIPOA ST
Practice Address - Street 2:SUITE 21
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8148
Practice Address - Country:US
Practice Address - Phone:808-875-0511
Practice Address - Fax:808-875-8595
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN279928363LA2200X
HIAPRN-1479363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health