Provider Demographics
NPI:1609995315
Name:HEPNER, ANGELA R (RD, CDE)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:HEPNER
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:R
Other - Last Name:HEPNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:740 S LIMESTONE
Mailing Address - Street 2:RM J449
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-323-5404
Mailing Address - Fax:859-323-8179
Practice Address - Street 1:2195 HARRODSBURG RD STE 125
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3504
Practice Address - Country:US
Practice Address - Phone:859-323-2232
Practice Address - Fax:859-257-0659
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1924133V00000X
KY122859133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered