Individual
LINDA DUPPONG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
602 ASH AVE, GLEN ULLIN, ND 58631
(701) 348-9175
(701) 348-9177
Mailing address
PO BOX 640, GLEN ULLIN, ND 58631-0640
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0021
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10485
—
ND
Enumeration date
01/05/2006
Last updated
07/08/2007
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