Basic Information
| Provider Information | |||||||||
| NPI: | 1609095470 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EPPERLY | ||||||||
| FirstName: | CHASITY | ||||||||
| MiddleName: | SHEA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 308 N MAPLE AVE | ||||||||
| Address2: | |||||||||
| City: | NEW HAMPTON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 506591142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6413942151 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3205 N ACADEMY BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809175147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196325700 | ||||||||
| FaxNumber: | 7193447814 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2007 | ||||||||
| LastUpdateDate: | 02/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 6672 | KS | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 38667 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | DR.0063681 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.