Healthcare Provider Details

I. General information

NPI: 1528970118
Provider Name (Legal Business Name): KABITA BASTOLA KARKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6155 WOODFIELD PL SE APT 1
GRAND RAPIDS MI
49548-8582
US

IV. Provider business mailing address

6155 WOODFIELD PL SE APT 1
GRAND RAPIDS MI
49548-8582
US

V. Phone/Fax

Practice location:
  • Phone: 616-375-1039
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: