Provider Demographics
NPI:1558769729
Name:HEDGEPETH, DENISE JANEL (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:JANEL
Last Name:HEDGEPETH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:JANEL
Other - Last Name:SHEPLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7658 POPLAR PIKE
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-5941
Mailing Address - Country:US
Mailing Address - Phone:703-727-7171
Mailing Address - Fax:
Practice Address - Street 1:7658 POPLAR PIKE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-5941
Practice Address - Country:US
Practice Address - Phone:901-759-2322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA00000026432643363AM0700X
VA0110004668363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical