Individual
SARAH SUPIRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15319 W 95TH ST, LENEXA, KS 66219-1262
(913) 495-9905
Mailing address
15319 W 95TH ST, LENEXA, KS 66219-1262
(913) 495-9905
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2015042086
MO
363LF0000X
Family Nurse Practitioner
Primary
5376931041
KS
Other
Enumeration date
12/30/2015
Last updated
05/01/2017
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