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NPI Code Detail

MEDICARE: LYNNANN KAPUSTKA MS, CCC-SLP

MEDICARE: LYNNANN KAPUSTKA MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistNE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12018OTHERNELISCENCE NUMBER

General Provider Information

NPI Number : 1396209102
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNNANN KAPUSTKA MS, CCC-SLP
Provider Business Mailing Address
First Line : PO BOX 154
Second Line :
City : SYRACUSE
State : NE
Zip : 68446-0154
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1322 U ST
Second Line :
City : AUBURN
State : NE
Zip : 68305-3215
Country : US
Telephone Number : 402-274-4954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2019
Last Update Date : 01/25/2019

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Directions to “ LYNNANN KAPUSTKA MS, CCC-SLP” Practice Location

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