Provider Demographics
NPI:1669952248
Name:SUPIK, KATHIE B (NP)
Entity type:Individual
Prefix:
First Name:KATHIE
Middle Name:B
Last Name:SUPIK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:106 FROGTOWN LANE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-2873
Mailing Address - Country:US
Mailing Address - Phone:828-369-0359
Mailing Address - Fax:877-673-6691
Practice Address - Street 1:106 FROGTOWN LANE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-5120
Practice Address - Country:US
Practice Address - Phone:828-369-0359
Practice Address - Fax:877-673-6691
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5010585207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine