Provider Demographics
NPI:1144455015
Name:KUPPER, CHIE JEAN (RNFA)
Entity type:Individual
Prefix:
First Name:CHIE
Middle Name:JEAN
Last Name:KUPPER
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 PHILADELPHIA DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-1840
Mailing Address - Country:US
Mailing Address - Phone:937-277-8988
Mailing Address - Fax:937-277-9035
Practice Address - Street 1:2200 PHILADELPHIA DR
Practice Address - Street 2:SUITE 101
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1840
Practice Address - Country:US
Practice Address - Phone:937-277-8988
Practice Address - Fax:937-277-9035
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN179415/NP02997163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant