Provider Demographics
NPI:1700526662
Name:DUPREE, CAROLYN S
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:S
Last Name:DUPREE
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:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:PLAIN DEALING
Mailing Address - State:LA
Mailing Address - Zip Code:71064-0024
Mailing Address - Country:US
Mailing Address - Phone:318-706-8153
Mailing Address - Fax:
Practice Address - Street 1:107 MONROVIA AVE
Practice Address - Street 2:
Practice Address - City:PLAIN DEALING
Practice Address - State:LA
Practice Address - Zip Code:71064-4461
Practice Address - Country:US
Practice Address - Phone:318-706-8153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant