Basic Information
| Provider Information | |||||||||
| NPI: | 1619043759 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZUPAN | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | CAROL | ||||||||
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| Credential: | APRN, CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 E 3RD ST | ||||||||
| Address2: | ESSENTIA HEALTH DULUTH CLINIC MCL2CRED | ||||||||
| City: | DULUTH | ||||||||
| State: | MN | ||||||||
| PostalCode: | 558051951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2187861183 | ||||||||
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| Practice Location | |||||||||
| Address1: | 115 10TH AVE NE STE A | ||||||||
| Address2: | |||||||||
| City: | DEER RIVER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 566368795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2182468275 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2006 | ||||||||
| LastUpdateDate: | 11/28/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R0929217 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.