Healthcare Provider Details

I. General information

NPI: 1548701733
Provider Name (Legal Business Name): JAMES MARTIN EPPERLY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 SWIFT BLVD
RICHLAND WA
99352-3514
US

IV. Provider business mailing address

1108 W 14TH AVE
KENNEWICK WA
99337-4012
US

V. Phone/Fax

Practice location:
  • Phone: 509-942-3627
  • Fax:
Mailing address:
  • Phone: 509-528-1279
  • Fax: 509-546-2262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN60094116
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: