Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 036099723 | IL |
Y | 207Q00000X | Family Doctor | 036099723 | IL |
NPI | 1003869280 |
---|---|
Provider Name | Dr. Valerie Ann Kupferer |
First Address | Murphysboro, IL 62966-1807 |
Second Address | Murphysboro, IL 62966-1807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 08/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
039-00152 | BCBS (01) | IL |
054378 | HEALTH ALLIANCE (01) | IL |
371134334001 | (05) | IL |
444492 | HEALTHLINK (01) | IL |
H16265 | (02) | IL |