Provider Demographics
NPI:1609095470
Name:EPPERLY, CHASITY SHEA (MD)
Entity Type:Individual
Prefix:
First Name:CHASITY
Middle Name:SHEA
Last Name:EPPERLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 N MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAMPTON
Mailing Address - State:IA
Mailing Address - Zip Code:50659-1142
Mailing Address - Country:US
Mailing Address - Phone:641-394-2151
Mailing Address - Fax:
Practice Address - Street 1:3205 N ACADEMY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5147
Practice Address - Country:US
Practice Address - Phone:719-632-5700
Practice Address - Fax:719-344-7814
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6672207Q00000X
IA38667207Q00000X
CODR.0063681207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine