| Doctor Name: | ASHLEY TUPPER |
| NPI Number: | 1316354590 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | 4704293226 |
| Business Practice Address: | 1121 Washington Blvd Newcastle, WY - 827012968 |
| Business Phone Number: | 3077463582 |
| Business Fax Number: | 6057550707 |
| Mailing Address: | 353 Fairmont Blvd, Attn Mss RAPID CITY |
| State: | SD |
| Postal Code: | 577017350 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/19/2014 |
| NPI Last Update Date: | 04/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704293226 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |