Provider Demographics
NPI:1992214969
Name:KRUPNIK, KATHRINE YVONNE (APRN-CNM)
Entity Type:Individual
Prefix:
First Name:KATHRINE
Middle Name:YVONNE
Last Name:KRUPNIK
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WASHINGTON PL
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6736
Mailing Address - Country:US
Mailing Address - Phone:603-695-2815
Mailing Address - Fax:
Practice Address - Street 1:5 WASHINGTON PL
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6736
Practice Address - Country:US
Practice Address - Phone:603-695-2815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH051983-23367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife