Provider Demographics
NPI:1962467183
Name:EPLEY, JAMES P (ARNP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:EPLEY
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-253-1035
Mailing Address - Fax:502-253-1037
Practice Address - Street 1:9115 LEESGATE RD
Practice Address - Street 2:SUITE A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5084
Practice Address - Country:US
Practice Address - Phone:502-429-8011
Practice Address - Fax:502-429-6389
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4186P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
037468OtherSIHO - NICC
000000541711OtherANTHEM - NICC
KY0998832Medicare PIN
Q04761Medicare UPIN