Provider Demographics
NPI:1699958934
Name:EPPERLY, JENNIFER L
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:EPPERLY
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 1:33 VALLEY RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906
Mailing Address - Country:US
Mailing Address - Phone:828-837-2790
Mailing Address - Fax:
Practice Address - Street 1:33 VALLEY RIVER AVE
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-2915
Practice Address - Country:US
Practice Address - Phone:828-837-2790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-10
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC600647167335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6041840001Medicare NSC