Provider Demographics
NPI:1386285609
Name:TOUPIN, KARISSA RAE (FNP)
Entity type:Individual
Prefix:
First Name:KARISSA
Middle Name:RAE
Last Name:TOUPIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 KELLOGG ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-8917
Mailing Address - Country:US
Mailing Address - Phone:910-964-8580
Mailing Address - Fax:
Practice Address - Street 1:1300 ACADEMY RD # 137
Practice Address - Street 2:
Practice Address - City:CULVER
Practice Address - State:IN
Practice Address - Zip Code:46511-1234
Practice Address - Country:US
Practice Address - Phone:574-842-7852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704272619363LF0000X
IN28196220A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily