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General NPI Number Information
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NPI Number | 1679311559
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Entity Type | Individual
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Provider Name | KALEY KIEPURA
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Gender | Female
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Dates
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Enumeration Date | 07/16/2024
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 10851 BROADWAY
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City | CROWN POINT
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State | IN
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Zip | 46307-7303
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Country | US
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Telephone | 219-763-8112
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Fax |
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Provider Business Mailing Address
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Address Line | 7110 W 127TH ST
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1571
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 71015502A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 209032781
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License Number State | IL
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