Healthcare Provider Details

I. General information

NPI: 1285358853
Provider Name (Legal Business Name): SUMMER MARIE HEPLER APRN-CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 MAPLEWOOD AVE
RONCEVERTE WV
24970-8016
US

IV. Provider business mailing address

1322 MAPLEWOOD AVE
RONCEVERTE WV
24970-8016
US

V. Phone/Fax

Practice location:
  • Phone: 304-647-5114
  • Fax:
Mailing address:
  • Phone: 304-647-5114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number114496
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: