Provider Demographics
NPI:1770123358
Name:DUPREE, JESSICA S
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:S
Last Name:DUPREE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 SECTION LINE RD
Mailing Address - Street 2:
Mailing Address - City:GURLEY
Mailing Address - State:AL
Mailing Address - Zip Code:35748-9190
Mailing Address - Country:US
Mailing Address - Phone:256-947-2724
Mailing Address - Fax:
Practice Address - Street 1:557 SECTION LINE RD
Practice Address - Street 2:
Practice Address - City:GURLEY
Practice Address - State:AL
Practice Address - Zip Code:35748-9190
Practice Address - Country:US
Practice Address - Phone:256-947-2724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide