Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP30004142 | WA |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP30004142 | WA |
NPI | 1003832445 |
---|---|
Provider Name | Barbara L Kapuscinski |
First Address | University Place, WA 98467-1415 |
Second Address | Tacoma, WA 98431-1100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 28/07/2020 |