Healthcare Provider Details

I. General information

NPI: 1144133638
Provider Name (Legal Business Name): MRS. STEPHANNE RYAN RUPNICKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 158TH RD
MAYETTA KS
66509-9097
US

IV. Provider business mailing address

8215 158TH RD
MAYETTA KS
66509-9097
US

V. Phone/Fax

Practice location:
  • Phone: 785-249-8155
  • Fax:
Mailing address:
  • Phone: 785-249-8155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: