Provider Demographics
NPI:1710522255
Name:DUPREE, PATRICIA DENISE (FNP-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DENISE
Last Name:DUPREE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14200 MERIDIAN PKWY # 101
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92518-3044
Mailing Address - Country:US
Mailing Address - Phone:951-653-0655
Mailing Address - Fax:951-653-0664
Practice Address - Street 1:14200 MERIDIAN PKWY # 101
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92518-3044
Practice Address - Country:US
Practice Address - Phone:951-653-0655
Practice Address - Fax:951-653-0664
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012740363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner