Provider Demographics
NPI:1053395228
Name:TIEPERMAN, SABRA LEIGH (RN ARNP)
Entity type:Individual
Prefix:
First Name:SABRA
Middle Name:LEIGH
Last Name:TIEPERMAN
Suffix:
Gender:F
Credentials:RN ARNP
Other - Prefix:
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Mailing Address - Street 1:821 WESTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-1670
Mailing Address - Country:US
Mailing Address - Phone:620-755-4235
Mailing Address - Fax:833-449-0970
Practice Address - Street 1:821 WESTRIDGE DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-1670
Practice Address - Country:US
Practice Address - Phone:620-755-4235
Practice Address - Fax:833-449-0970
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2024-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS53-74804-102364SP0809X, 364SP0807X, 364SP0808X, 364SP0811X, 364SP0812X, 364SP0813X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No364SP0811XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Chronically Ill
No364SP0812XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Community
No364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Geropsychiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30004436160004Medicaid
P64814Medicare UPIN