Provider Demographics
NPI:1871894329
Name:HEPNER, ASHLEY C (ANP-BC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:C
Last Name:HEPNER
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 W VERDE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-6162
Mailing Address - Country:US
Mailing Address - Phone:602-489-9740
Mailing Address - Fax:
Practice Address - Street 1:11333 N SCOTTSDALE RD STE 230
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5188
Practice Address - Country:US
Practice Address - Phone:480-000-0000
Practice Address - Fax:480-631-7374
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.290382163W00000X
AZAP4677363LG0600X, 363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ753106Medicaid
OH3108550Medicaid
OHHENP38941Medicare PIN
AZZ92677Medicare PIN