Provider Demographics
NPI:1669549689
Name:DUPRE, KATE B (PHD APRN CS BC)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:B
Last Name:DUPRE
Suffix:
Gender:F
Credentials:PHD APRN CS BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:592 HUMPHREY ST
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2655
Mailing Address - Country:US
Mailing Address - Phone:508-947-8551
Mailing Address - Fax:508-947-8521
Practice Address - Street 1:17 W END AVE
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346
Practice Address - Country:US
Practice Address - Phone:855-872-7543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA91975363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1892762Medicaid
MA1892762Medicaid
S70194Medicare UPIN