Individual provider · Type 1 NPI

Willard Keith Cupp Iii, PMHNP

Psychiatric/Mental Health Nurse Practitioner · Elkhart, IN

NPI number 1265021406 Active

Practice location

236 Simpson Ave
Elkhart, IN 46516-4666

Specialties and licenses

Taxonomy	Code	License
Psychiatric/Mental Health Nurse Practitioner Primary	363LP0808X	71010753A (IN)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1265021406

Willard Keith Cupp Iii, PMHNP's National Provider Identifier is 1265021406, issued on Jan 12, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Elkhart, IN. The record was last updated on Nov 3, 2023.