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General NPI Number Information
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NPI Number | 1679415814
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Entity Type | Individual
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Provider Name | KAITLYN SUPPES
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Gender | Female
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 514 CLEVELAND ST
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City | GREAT BEND
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State | KS
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Zip | 67530-3562
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Country | US
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Telephone | 620-792-8833
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Fax |
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Provider Business Mailing Address
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Address Line | 514 CLEVELAND ST
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City | GREAT BEND
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State | KS
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Zip | 67530-3562
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Country | US
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Telephone | 620-792-8833
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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 | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | 13-165692-051
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License Number State | KS
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