Individual
MITCHELL J KUPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965
Mailing address
8301 S BRETT AVE, SIOUX FALLS, SD 57108-6329
(605) 949-1417
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
113976
SD
367500000X
Certified Registered Nurse Anesthetist
Primary
264164
WI
Other
Enumeration date
03/20/2017
Last updated
05/21/2024
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