Healthcare Provider Details

I. General information

NPI: 1447080544
Provider Name (Legal Business Name): AUTUM MICHELLE KAPINKIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 S BROWN AVE
DENISON TX
75020-5220
US

IV. Provider business mailing address

909 S BROWN AVE
DENISON TX
75020-5220
US

V. Phone/Fax

Practice location:
  • Phone: 775-225-3158
  • Fax:
Mailing address:
  • Phone: 775-225-3158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1250195
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number982598
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: