Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 71572 | WI |
N | 207VX0201X | Gynecologic Oncologist | Q1136 | TX |
NPI | 1326105511 |
---|---|
Provider Name | Nefertiti C Dupont |
First Address | Shenandoah, TX 77380-3222 |
Second Address | La Crosse, WI 54601-5429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 02/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03023094 | (05) | NY |
337897801 | (05) | TX |
337897802 | (05) | TX |
361605YK26 | (02) | TX |
361605YMCG | (02) | TX |