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NPI Code Detail

MEDICARE: MS. KATHERINE MAPLES NOVOTNY RN

MEDICARE: MS. KATHERINE MAPLES NOVOTNY RN
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
1163WX0002XHigh-Risk Obstetric Registered Nurse328999AZ

General Provider Information

NPI Number : 1962361923
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHERINE MAPLES NOVOTNY RN
Provider Business Mailing Address
First Line : 2443 S POLARIS WAY
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-2074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1200 N BEAVER ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-3118
Country : US
Telephone Number : 928-773-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

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