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Individual

MARK THOMAS HEPWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1200 1ST AVE E STE 1, SPENCER, IA 51301-4330
(712) 264-6228
Mailing address
1200 1ST AVE E STE 1, SPENCER, IA 51301-4330
(712) 264-6228

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G162956
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G162956
ARNP LICENSE NUMBER
IA
Enumeration date
03/31/2021
Last updated
03/31/2021
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