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Individual

JENNIFER A. HUPKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
6201 S. MINNESOTA AVE, TEA, SD 57108-2559
(605) 274-6717
(605) 275-4804
Mailing address
6201 S. MINNESOTA AVE, TEA, SD 57108-2559
(605) 274-6717
(605) 275-4804

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
0593
SD
152W00000X
Optometrist
Primary
593
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0040692
BLUE CROSS BLUE SHIELD
SD
01
30671
SIOUX VALLEY HEALTH PLAN
SD
05
9201722
SD
05
9201723
SD
05
9201724
SD
01
9212280
DAKOTA CARE
SD
01
SD0593
EYEMED
SD
Enumeration date
05/04/2006
Last updated
05/20/2019
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