Provider Demographics
NPI:1275855546
Name:KAPUSTINSKI, KATHRYN ELIZABETH (RPA-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:KAPUSTINSKI
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ELIZABETH
Other - Last Name:STURGEON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPA-C
Mailing Address - Street 1:PO BOX 33173
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78265-3173
Mailing Address - Country:US
Mailing Address - Phone:210-890-8840
Mailing Address - Fax:210-783-9089
Practice Address - Street 1:136 DRIFTING WIND RUN STE 117
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-5628
Practice Address - Country:US
Practice Address - Phone:512-737-5945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13606363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant