Provider Demographics
NPI:1528495892
Name:DUPONT, CHARMELLE P
Entity type:Individual
Prefix:MISS
First Name:CHARMELLE
Middle Name:P
Last Name:DUPONT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 W 54TH ST
Mailing Address - Street 2:APT D
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-3253
Mailing Address - Country:US
Mailing Address - Phone:912-508-3661
Mailing Address - Fax:
Practice Address - Street 1:27 W 54TH ST
Practice Address - Street 2:APT D
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-3253
Practice Address - Country:US
Practice Address - Phone:912-508-3661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion