Provider Demographics
NPI:1760011050
Name:KEPNER, JILL KATHLEEN (CRNP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:KATHLEEN
Last Name:KEPNER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6618 ROCKFORD DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-2744
Mailing Address - Country:US
Mailing Address - Phone:304-596-3763
Mailing Address - Fax:
Practice Address - Street 1:8130 ADAMS DR
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-8623
Practice Address - Country:US
Practice Address - Phone:717-967-8288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021683363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health