Provider Demographics
NPI:1861067944
Name:PEPPER, KRISTALYN HOLLAND (NP)
Entity type:Individual
Prefix:MRS
First Name:KRISTALYN
Middle Name:HOLLAND
Last Name:PEPPER
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:7551 YOUREE DR STE 11
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5533
Mailing Address - Country:US
Mailing Address - Phone:318-642-9282
Mailing Address - Fax:833-749-0340
Practice Address - Street 1:7551 YOUREE DR STE 11
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5533
Practice Address - Country:US
Practice Address - Phone:318-642-9282
Practice Address - Fax:833-749-0340
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2022-11-22
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Provider Licenses
StateLicense IDTaxonomies
LA220267363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner