Healthcare Provider Details

I. General information

NPI: 1053395228
Provider Name (Legal Business Name): SABRA LEIGH TIEPERMAN RN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 WESTRIDGE DR
NEWTON KS
67114-1670
US

IV. Provider business mailing address

821 WESTRIDGE DR
NEWTON KS
67114-1670
US

V. Phone/Fax

Practice location:
  • Phone: 620-755-4235
  • Fax: 833-449-0970
Mailing address:
  • Phone: 620-755-4235
  • Fax: 833-449-0970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number53-74804-102
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number53-74804-102
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number53-74804-102
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code364SP0811X
TaxonomyChronically Ill Psychiatric/Mental Health Clinical Nurse Specialist
License Number53-74804-102
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code364SP0812X
TaxonomyCommunity Psychiatric/Mental Health Clinical Nurse Specialist
License Number53-74804-102
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code364SP0813X
TaxonomyGeropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
License Number53-74804-102
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: