Provider Demographics
NPI:1326004458
Name:EPPERLY, CAROLYN L (PHD RNCS)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:L
Last Name:EPPERLY
Suffix:
Gender:F
Credentials:PHD RNCS
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Mailing Address - Street 1:1011 BROOKSIDE RD
Mailing Address - Street 2:STE 280
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106
Mailing Address - Country:US
Mailing Address - Phone:610-366-1516
Mailing Address - Fax:610-366-7756
Practice Address - Street 1:1011 BROOKSIDE RD
Practice Address - Street 2:STE 280
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106
Practice Address - Country:US
Practice Address - Phone:610-366-1516
Practice Address - Fax:610-366-7756
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN161847L364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
2318652000OtherAMERIHEALTH
59560894OtherUNITED BEH HEALTH
4607619OtherAETNA
4607619OtherAETNA