Provider Demographics
NPI:1114369196
Name:CHALUPSKY, PAULINA (NP)
Entity type:Individual
Prefix:
First Name:PAULINA
Middle Name:
Last Name:CHALUPSKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 OUTER DR
Mailing Address - Street 2:
Mailing Address - City:SILVER BAY
Mailing Address - State:MN
Mailing Address - Zip Code:55614-1133
Mailing Address - Country:US
Mailing Address - Phone:218-353-8709
Mailing Address - Fax:218-226-6107
Practice Address - Street 1:56 OUTER DR
Practice Address - Street 2:
Practice Address - City:SILVER BAY
Practice Address - State:MN
Practice Address - Zip Code:55614-1133
Practice Address - Country:US
Practice Address - Phone:218-353-8709
Practice Address - Fax:218-226-6107
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR190097-6363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1114369196Medicaid
WI1114369196Medicaid
MN0001-0103723OtherMEDICA