Provider Demographics
NPI:1770029597
Name:KEPFER, CYNTHIA (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:KEPFER
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-2258
Mailing Address - Country:US
Mailing Address - Phone:772-222-5001
Mailing Address - Fax:772-492-3786
Practice Address - Street 1:1702 CLUB DR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-2258
Practice Address - Country:US
Practice Address - Phone:772-222-5001
Practice Address - Fax:772-492-3786
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-18
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9316661363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health