Provider Demographics
NPI:1396733168
Name:EPPLETT, CAROLYN S (CNP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:S
Last Name:EPPLETT
Suffix:
Gender:F
Credentials:CNP
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Mailing Address - Street 1:501 LAPEER
Mailing Address - Street 2:HEALTH DELIVERY INC
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1208
Mailing Address - Country:US
Mailing Address - Phone:989-759-6400
Mailing Address - Fax:989-759-6423
Practice Address - Street 1:229 GALLAGHER ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-3252
Practice Address - Country:US
Practice Address - Phone:989-755-3619
Practice Address - Fax:989-755-3624
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2010-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704101105363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1010613OtherMCLAREN HEALTH PLAN
139493OtherGREAT LAKES HEALTH PLAN
MI4151470Medicaid
4151470OtherMOLINA HEALTH CARE OF MIC
MI1396733168Medicaid
381908328OtherUNDER
MI500008354OtherUNITED HEALTHCARE
MI147OtherCARE SOURCE OF MICHIGAN
1010613OtherHEALTH ADVANTAGE PPO
500008354OtherRAILROAD MEDICARE
500G310570OtherBCBS OF MI
139493OtherGREAT LAKES HEALTH PLAN
MI1396733168Medicaid
MI147OtherCARE SOURCE OF MICHIGAN