Healthcare Provider Details

I. General information

NPI: 1497890149
Provider Name (Legal Business Name): SANDRA JEAN HEPKER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 EAST SAINT JOE STREET PROFESSIONAL HEARING SERVICES
HILLSDALE MI
49242
US

IV. Provider business mailing address

67 EAST SAINT JOE STREET
HILLSDALE MI
49242
US

V. Phone/Fax

Practice location:
  • Phone: 517-439-1610
  • Fax: 517-439-5679
Mailing address:
  • Phone: 517-439-1610
  • Fax: 517-439-5679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601000348
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: