1396733168 NPI number — CAROLYN S EPPLETT CNP

Table of content: CAROLYN S EPPLETT CNP (NPI 1396733168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396733168 NPI number — CAROLYN S EPPLETT CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EPPLETT
Provider First Name:
CAROLYN
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396733168
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 LAPEER
Provider Second Line Business Mailing Address:
HEALTH DELIVERY INC
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48607-1208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-759-6400
Provider Business Mailing Address Fax Number:
989-759-6423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
229 GALLAGHER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48601-3252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-755-3619
Provider Business Practice Location Address Fax Number:
989-755-3624
Provider Enumeration Date:
10/06/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  4704101105 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1010613 . This is a "MCLAREN HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 139493 . This is a "GREAT LAKES HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4151470 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4151470 . This is a "MOLINA HEALTH CARE OF MIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1396733168 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 381908328 . This is a "UNDER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 500008354 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 147 . This is a "CARE SOURCE OF MICHIGAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1010613 . This is a "HEALTH ADVANTAGE PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 500008354 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 500G310570 . This is a "BCBS OF MI" identifier . This identifiers is of the category "OTHER".




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