Healthcare Provider Details

I. General information

NPI: 1679644389
Provider Name (Legal Business Name): WENDY K. HEPNER M.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29101 HEALTH CAMPUS DR SUITE 290
WESTLAKE OH
44145-5270
US

IV. Provider business mailing address

29101 HEALTH CAMPUS DR SUITE 290
WESTLAKE OH
44145-5270
US

V. Phone/Fax

Practice location:
  • Phone: 440-835-6160
  • Fax: 440-899-4373
Mailing address:
  • Phone: 440-835-6160
  • Fax: 440-899-4373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-0961
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: