Individual
MS. LORI J CHUPP
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M PA-S
Contact information
Practice address
5955 ZEAMER AVE, 3 MDOS / SGOEF, ELMENDORF AFB, AK 99506-3702
(907) 580-2318
Mailing address
11231 BRIDGER PL, EAGLE RIVER, AK 99577-8012
(907) 622-7722
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1032481
—
Other
Enumeration date
11/30/2005
Last updated
07/08/2007
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