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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NI KETUT SUPIYATI

Active Sole Proprietor

NI KETUT SUPIYATI is a Nurse Practitioner healthcare provider located in HUNTINGTON PARK, California. NPI 1023497443 is currently active in the NPPES registry. Verify at CMS.

Nurse Practitioner · HUNTINGTON PARK, CA

Registration Details

NPI Number
1023497443
Provider Type
Individual
Gender
Female
NPI Issued
May 19, 2015 (11.215957658824 yrs)
Last Updated
May 19, 2015
License
NP95001498 (CA)
Sole Proprietor
Yes

Practice Information

Address
2638 E FLORENCE AVE
HUNTINGTON PARK, CA, 902554708
Browse CA providers · Browse ZIP 90255
Phone
3235814665
Fax
3235810551
Primary Specialty
Nurse Practitioner
363L00000X

Other Nurse Practitioner Providers in HUNTINGTON PARK, CA

Name Credential NPI
MS. GLENDA MULET BURGOS FNP 1306886684
MRS. CARMEN EDITH BRITO N.P. 1427160886
SHARI LAVERNE MCNAIR NP 1700988631
KATHLEEN AHN NP 1891083804
MRS. SONYA AMBRIZ 1336717487
AMERICA OBEZO NP-C 1538832837
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.