# KATHIE B SUPIK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1669952248
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 5010585 | NC | Yes |

## Other

- **Enumeration date:** 08/14/2018
- **Last updated:** 06/02/2025