Provider Demographics
NPI:1295045821
Name:HEPNER, BETHANY LYNNE
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:LYNNE
Last Name:HEPNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-3538
Mailing Address - Country:US
Mailing Address - Phone:330-823-0850
Mailing Address - Fax:
Practice Address - Street 1:1895 W STATE ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-3538
Practice Address - Country:US
Practice Address - Phone:330-823-0850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-17
Last Update Date:2010-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH03230539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist