Individual
CONSTANCE FAITH SOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3902 13TH AVE S, FARGO, ND 58103-3357
(701) 364-6600
(701) 364-6628
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0395
ND
Other
Enumeration date
07/23/2008
Last updated
02/08/2021
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