Healthcare Provider Details

I. General information

NPI: 1790255172
Provider Name (Legal Business Name): MEGHAN HEPLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 BOULEVARD NE STE 500
ATLANTA GA
30312-1266
US

IV. Provider business mailing address

1151 AURORA CT
DUNWOODY GA
30338-2603
US

V. Phone/Fax

Practice location:
  • Phone: 404-265-3635
  • Fax:
Mailing address:
  • Phone: 678-777-5605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number232026
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number232026
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: