Provider Demographics
NPI:1780851220
Name:HEPLER, AMANDA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JEAN
Last Name:HEPLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:JEAN
Other - Last Name:STOREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1222 PUTNEY RD STE 7
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-9000
Mailing Address - Country:US
Mailing Address - Phone:802-490-2099
Mailing Address - Fax:802-579-1228
Practice Address - Street 1:1222 PUTNEY RD STE 7
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-9000
Practice Address - Country:US
Practice Address - Phone:802-490-2099
Practice Address - Fax:802-579-1228
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0012824207QH0002X
390200000X
PA017845207Q00000X
VT042-0012824207Q00000X
NH15796207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077616Medicaid
ME432996399Medicaid
ME000668101Medicare PIN
ME432996399Medicaid
VTY400126240Medicare PIN