Provider Demographics
NPI:1326197468
Name:KEPNER, BARBARA J (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:KEPNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:J
Other - Last Name:GERBICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:515 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-1569
Mailing Address - Country:US
Mailing Address - Phone:608-324-1000
Mailing Address - Fax:
Practice Address - Street 1:515 22ND AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-1569
Practice Address - Country:US
Practice Address - Phone:608-324-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-083012208D00000X
WI43932208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
13260OtherDEAN HEALTH PLAN
90002361OtherWEA INS
34167700OtherHIRSP
1040278OtherPHYSICIANS PLUS
390808509OtherCT GENERAL
390808509OtherWPS
970000179OtherMEDICARE RAILROAD
WI34167700Medicaid
36083012OtherILLINOIS PUBLIC AID
390808509OtherCIGNA
390808509ZMOtherUNITY
690004890OtherMEDICARE RAILROAD
390808509ZJOtherUNITY
390808509OtherWPS
36083012OtherILLINOIS PUBLIC AID
A03256Medicare UPIN