Provider Demographics
NPI:1215152004
Name:KAPPUS, CYNTHIA DIANE (APRN, NP, CNS)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DIANE
Last Name:KAPPUS
Suffix:
Gender:F
Credentials:APRN, NP, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 NW 39TH EXPY
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2513
Mailing Address - Country:US
Mailing Address - Phone:405-440-9866
Mailing Address - Fax:405-438-3834
Practice Address - Street 1:6800 NW 39TH EXPY
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-2513
Practice Address - Country:US
Practice Address - Phone:405-440-9866
Practice Address - Fax:405-438-3834
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK59778364SA2100X, 364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK59778OtherAACCN-PEDS CNS LICENSE
MO2013041635OtherAPRN CCNS-P