Provider Demographics
NPI:1437306644
Name:HART-KEPLER, VIRGINIA (MN RN FNP-C)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:HART-KEPLER
Suffix:
Gender:F
Credentials:MN RN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 S PARK AVE
Mailing Address - Street 2:ROOM 101
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-3129
Mailing Address - Country:US
Mailing Address - Phone:909-622-6516
Mailing Address - Fax:
Practice Address - Street 1:750 S PARK AVE
Practice Address - Street 2:ROOM 101
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-3129
Practice Address - Country:US
Practice Address - Phone:909-622-6516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA629729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily