Provider Demographics
NPI:1790944296
Name:HEPNER, NATHANIAL JAMES (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:NATHANIAL
Middle Name:JAMES
Last Name:HEPNER
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2153
Mailing Address - Country:US
Mailing Address - Phone:970-576-8212
Mailing Address - Fax:
Practice Address - Street 1:600 PARK ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-4099
Practice Address - Country:US
Practice Address - Phone:785-628-5285
Practice Address - Fax:785-628-4043
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-00581174400000X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No174400000XOther Service ProvidersSpecialist