Provider Demographics
NPI:1558848317
Name:OPLINGER, ALLIE (PA-C)
Entity Type:Individual
Prefix:
First Name:ALLIE
Middle Name:
Last Name:OPLINGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:
Other - Last Name:VANDENBERGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1210 W 18TH ST STE G01
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-4651
Mailing Address - Country:US
Mailing Address - Phone:605-328-2663
Mailing Address - Fax:605-328-3760
Practice Address - Street 1:1210 W 18TH ST STE G01
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104
Practice Address - Country:US
Practice Address - Phone:605-328-2663
Practice Address - Fax:605-328-3760
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant