Basic Information
| Provider Information | |||||||||
| NPI: | 1285358853 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEPLER | ||||||||
| FirstName: | SUMMER | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | APRN-CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1322 MAPLEWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | RONCEVERTE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249708016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046475114 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1322 MAPLEWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | RONCEVERTE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249708016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046475114 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2022 | ||||||||
| LastUpdateDate: | 09/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 114496 | WV | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 114496 | 01 | WV | LICENSE | OTHER |