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NPI Code Detail

MEDICARE: KAITLYN SUPPES

MEDICARE: KAITLYN SUPPES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WX0003XInpatient Obstetric Registered Nurse13-165692-051KS

General Provider Information

NPI Number : 1679415814
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN SUPPES
Provider Business Mailing Address
First Line : 514 CLEVELAND ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3562
Country : US
Telephone Number : 620-792-8833
Fax Number :
Provider Business Practice Location Address
First Line : 514 CLEVELAND ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-3562
Country : US
Telephone Number : 620-792-8833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ KAITLYN SUPPES ” Practice Location

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