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General NPI Number Information
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NPI Number | 1699723387
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Entity Type | Individual
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Provider Name | JENNIFER A. HUPKE O.D.
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Gender | Female
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 6201 S. MINNESOTA AVE
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City | TEA
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State | SD
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Zip | 57108-2559
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Country | US
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Telephone | 605-274-6717
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Fax | 605-275-4804
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Provider Business Mailing Address
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Address Line | 6201 S. MINNESOTA AVE
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City | TEA
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State | SD
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Zip | 57108-2559
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Country | US
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Telephone | 605-274-6717
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Fax | 605-275-4804
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0593
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 593
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License Number State | SD
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