Provider Demographics
NPI:1881672988
Name:DUPREY, PATTI L (ARNP)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:L
Last Name:DUPREY
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 1:57 PORTLAND ROAD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6031
Mailing Address - Country:US
Mailing Address - Phone:207-467-3777
Mailing Address - Fax:888-312-0662
Practice Address - Street 1:57 PORTLAND ROAD
Practice Address - Street 2:SUITE 5
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043
Practice Address - Country:US
Practice Address - Phone:207-467-3777
Practice Address - Fax:888-312-0662
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH032355-23363LF0000X
MECNP121019363LF0000X
NH032355-23-03363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010058Medicaid
NHNP0689Medicare ID - Type Unspecified
S30927Medicare UPIN