Provider Demographics
NPI:1255658522
Name:DUPREE, DIANE
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:
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 1:5067 SILVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:W BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3373
Mailing Address - Country:US
Mailing Address - Phone:248-470-5644
Mailing Address - Fax:866-343-1216
Practice Address - Street 1:5067 SILVERWOOD DR
Practice Address - Street 2:
Practice Address - City:W BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3373
Practice Address - Country:US
Practice Address - Phone:248-470-5644
Practice Address - Fax:866-343-1216
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide