Provider Demographics
NPI:1548226699
Name:DUPEN, ANNA (ARNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:DUPEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 CHERRY AVE
Mailing Address - Street 2:#213
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-4203
Mailing Address - Country:US
Mailing Address - Phone:360-479-6041
Mailing Address - Fax:
Practice Address - Street 1:2601 CHERRY AVE
Practice Address - Street 2:#213
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-4203
Practice Address - Country:US
Practice Address - Phone:360-479-6041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003292363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9652793Medicaid
WA9652793Medicaid
WA8865293Medicare PIN