Healthcare Provider Details

I. General information

NPI: 1881123040
Provider Name (Legal Business Name): KATHERINE ANNE KUPFER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 BUTTERFLY GARDENS DR.
COLUMBUS OH
42315-7508
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-938-0167
  • Fax: 614-938-0170
Mailing address:
  • Phone: 614-722-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP021177
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: