Provider Demographics
NPI:1275111783
Name:KARTUPELIS, RAEGAN LAYHER (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:RAEGAN
Middle Name:LAYHER
Last Name:KARTUPELIS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MISS
Other - First Name:RAEGAN
Other - Middle Name:A
Other - Last Name:LAYHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1028 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:WY
Mailing Address - Zip Code:82633-2826
Mailing Address - Country:US
Mailing Address - Phone:307-359-9265
Mailing Address - Fax:
Practice Address - Street 1:6631 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4355
Practice Address - Country:US
Practice Address - Phone:307-268-9904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY53587364SP0808X, 363LP0808X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program