Provider Demographics
NPI:1194393744
Name:EPPEN, AUSTEN
Entity Type:Individual
Prefix:
First Name:AUSTEN
Middle Name:
Last Name:EPPEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8086 S MEADOWCREEK CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8350
Mailing Address - Country:US
Mailing Address - Phone:224-944-1542
Mailing Address - Fax:
Practice Address - Street 1:8086 S MEADOWCREEK CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8350
Practice Address - Country:US
Practice Address - Phone:224-944-1542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer