Individual
TABITHA NORTHRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Mailing address
25434 183RD ST, LEAVENWORTH, KS 66048-8343
(307) 575-2463
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13164380111
KS
Other
Enumeration date
01/10/2025
Last updated
01/10/2025
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