Basic Information
Provider Information
NPI: 1619537677
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIEPE
FirstName: KAREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
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Mailing Information
Address1: 8181 NW 154TH ST STE 200
Address2:  
City: MIAMI LAKES
State: FL
PostalCode: 330165861
CountryCode: US
TelephoneNumber: 3055583724
FaxNumber: 7862600019
Practice Location
Address1: 500 UNIVERSITY BLVD STE 208
Address2:  
City: JUPITER
State: FL
PostalCode: 334582775
CountryCode: US
TelephoneNumber: 6162453115
FaxNumber: 5616254624
Other Information
ProviderEnumerationDate: 06/20/2019
LastUpdateDate: 08/20/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XAPRN11002848FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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