Kupchock, Sally

Kupchock, Sally is an individual health care provider with primary practice located at 1182 E 21St St , Idaho Falls ID 83404-7003. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Kupchock, Sally can be contacted via phone (208) 227-6753.

Contact Information

Primary practice address
1182 E 21St St Idaho Falls ID 83404-7003
Phone: (208) 227-6753
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP737A Idaho

Profile Details

NPI number 1063446094
LBN Legal business name Kupchock, Sally
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Nov 30th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063446094 NPPES
Idaho Other NPXT3 BLUE CROSS ID

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