MEDICARE: JAMES P EPLEY ARNP

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	363L00000X	Nurse Practitioner	4186P	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	037468	OTHER		SIHO - NICC
2	000000541711	OTHER		ANTHEM - NICC

General Provider Information

NPI Number	:	1962467183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES P EPLEY ARNP

Provider Business Mailing Address
First Line	:	PO BOX 950248
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40295-0248
Country	:	US
Telephone Number	:	502-253-1035
Fax Number	:	502-253-1037

Provider Business Practice Location Address
First Line	:	9115 LEESGATE RD
Second Line	:	SUITE A
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-5084
Country	:	US
Telephone Number	:	502-429-8011
Fax Number	:	502-429-6389

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	08/26/2014

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