Provider Demographics
NPI:1891426334
Name:DUPLIN, JESSICA MICHELLE (APRN)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:MICHELLE
Last Name:DUPLIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 EAGLE ST STE 4
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4776
Mailing Address - Country:US
Mailing Address - Phone:413-347-4088
Mailing Address - Fax:
Practice Address - Street 1:53 EAGLE ST STE 4
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4776
Practice Address - Country:US
Practice Address - Phone:413-347-4088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2369581363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily