Provider Demographics
NPI:1700410172
Name:DUPRIEST, ANDREA M (LVN)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:M
Last Name:DUPRIEST
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 EARLY FAWN CT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-8910
Mailing Address - Country:US
Mailing Address - Phone:817-734-4246
Mailing Address - Fax:
Practice Address - Street 1:2908 EARLY FAWN CT
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-8910
Practice Address - Country:US
Practice Address - Phone:817-734-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231707164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse