Provider Demographics
NPI:1750518486
Name:KAPAUN, NAOMI CLAIRE (MOT)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:CLAIRE
Last Name:KAPAUN
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17645 GULL LAKE LOOP RD NE
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-6920
Mailing Address - Country:US
Mailing Address - Phone:218-586-3592
Mailing Address - Fax:
Practice Address - Street 1:17645 GULL LAKE LOOP RD NE
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-6920
Practice Address - Country:US
Practice Address - Phone:218-586-3592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-21
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101617225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist