Healthcare Provider Details

I. General information

NPI: 1780465823
Provider Name (Legal Business Name): CAROLINE FRANCES HEPPNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N COLLEGE AVE
ANNVILLE PA
17003-1404
US

IV. Provider business mailing address

17 SPRING ISLAND DR
OKATIE SC
29909-4005
US

V. Phone/Fax

Practice location:
  • Phone: 866-582-4236
  • Fax:
Mailing address:
  • Phone: 434-841-6947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: