Individual
DEBORAH LEE SUPPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2000 NORTH AVE, NORTHFIELD, MN 55057-1498
(507) 646-1478
(507) 646-1393
Mailing address
2000 NORTH AVE, NORTHFIELD, MN 55057-1498
(507) 646-1478
(507) 646-1393
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
43578
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160060011
RAIL ROAD MEDICARE
—
05
—
690929900
—
MN
Enumeration date
07/17/2006
Last updated
03/10/2021
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