Provider Demographics
NPI:1750908620
Name:DUPREE, TAMMY K (FNP)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:K
Last Name:DUPREE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 BROOKS # 321
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75657-4443
Mailing Address - Country:US
Mailing Address - Phone:903-930-5707
Mailing Address - Fax:
Practice Address - Street 1:321 BROOKS # 321
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:TX
Practice Address - Zip Code:75657-4443
Practice Address - Country:US
Practice Address - Phone:903-930-5707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP146019363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty