Ni Ketut Supiyati
Ni Ketut Supiyati is a Nurse Practitioner in Huntington Park, California. Practices as a sole proprietor. Licensed in California.
- Licensed in
- CA
- In the registry since
- 2015
Practice location Address checks out
2638 E Florence AveHuntington Park, CA 90255-4708
Phone: (323) 581-4665
Fax: (323) 581-0551
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X · Licence NP95001498 (CA) |
|---|
Record details
| NPI number | 1023497443 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | May 19, 2015 |
| Last updated in NPPES | May 19, 2015 |
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