Provider Demographics
NPI:1548791395
Name:KAPA, NATHAN (CP)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:KAPA
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3487 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3025
Mailing Address - Country:US
Mailing Address - Phone:810-733-3375
Mailing Address - Fax:810-733-0117
Practice Address - Street 1:3487 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3025
Practice Address - Country:US
Practice Address - Phone:810-733-3375
Practice Address - Fax:810-733-0117
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist