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Individual

STEPHANIE L DUPAUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
640 JACKSON ST, MAIL STOP 11503P, ST PAUL, MN 55101-2502
(651) 254-3456
(651) 254-3048
Mailing address
8100 34TH AVE S, 21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-7961
(952) 883-5395

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
13203
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
R1417786
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1285601377
WI
05
690951500
MN
Enumeration date
03/07/2006
Last updated
10/26/2022
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