Provider Demographics
NPI:1568854974
Name:EPKEY, KATHRYN EILEEN (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:EILEEN
Last Name:EPKEY
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:EILEEN
Other - Last Name:GERBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MSD
Mailing Address - Street 1:411 28TH STREET
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:WV
Mailing Address - Zip Code:26105
Mailing Address - Country:US
Mailing Address - Phone:304-305-1445
Mailing Address - Fax:304-305-1446
Practice Address - Street 1:411 28TH STREET
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:WV
Practice Address - Zip Code:26105
Practice Address - Country:US
Practice Address - Phone:304-305-1445
Practice Address - Fax:304-305-1446
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-21
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV00304753888Medicaid
WVWVTPID008411Medicaid