Provider Demographics
NPI:1821513797
Name:EPPERSON, ILONA
Entity Type:Individual
Prefix:
First Name:ILONA
Middle Name:
Last Name:EPPERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10677 EGGBORNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:RIXEYVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22737-2143
Mailing Address - Country:US
Mailing Address - Phone:540-229-3969
Mailing Address - Fax:
Practice Address - Street 1:10677 EGGBORNSVILLE RD
Practice Address - Street 2:
Practice Address - City:RIXEYVILLE
Practice Address - State:VA
Practice Address - Zip Code:22737-2143
Practice Address - Country:US
Practice Address - Phone:540-229-3969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver