Healthcare Provider Details

I. General information

NPI: 1821433962
Provider Name (Legal Business Name): COURTNEY HEPNER CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 THORNTON PKWY
THORNTON CO
80229-2100
US

IV. Provider business mailing address

7575 E ARKANSAS AVE APT 15-203
DENVER CO
80231-2500
US

V. Phone/Fax

Practice location:
  • Phone: 303-252-0005
  • Fax:
Mailing address:
  • Phone: 303-579-4268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1413258
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: