Healthcare Provider Details

I. General information

NPI: 1427159110
Provider Name (Legal Business Name): DONNA HEPBURN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 ADAMS ST
BEDFORD HILLS NY
10507-2001
US

IV. Provider business mailing address

1 CARRIAGE HOUSE LN
BROOKFIELD CT
06804-3919
US

V. Phone/Fax

Practice location:
  • Phone: 914-241-5158
  • Fax: 914-242-5152
Mailing address:
  • Phone: 914-241-0758
  • Fax: 914-242-5152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR53973
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400728-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: