Individual
KAITLYN TAMBKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP - PC
Contact information
Practice address
3348 AMERICAN AVE, JEFFERSON CITY, MO 65109-1079
(573) 761-7210
(573) 634-8802
Mailing address
PO BOX 1027, JEFFERSON CITY, MO 65102-1027
(573) 681-3767
(573) 681-3593
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2020025672
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
2025037520
MO
Other
Enumeration date
08/11/2025
Last updated
09/09/2025
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