MEDICARE: DR. MICHELLE HEPPNER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	010455816	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	434046	OTHER	ANTHEM
2	0192072	OTHER	CIGNA
3	148280	OTHER	SOUTHERN HEALTH

General Provider Information

NPI Number	:	1417032681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE HEPPNER DC

Provider Business Mailing Address
First Line	:	1544 INSURANCE LN
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22911-7229
Country	:	US
Telephone Number	:	434-962-9310
Fax Number	:	434-974-9182

Provider Business Practice Location Address
First Line	:	1544 INSURANCE LN
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22911-7229
Country	:	US
Telephone Number	:	434-962-9310
Fax Number	:	434-974-9182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	03/16/2023

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