Provider Demographics
NPI:1871380071
Name:DUPRE, DANIELLE (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:DUPRE
Suffix:
Gender:
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5725 S VALLEY VIEW BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-3122
Mailing Address - Country:US
Mailing Address - Phone:760-235-9365
Mailing Address - Fax:
Practice Address - Street 1:5725 S VALLEY BLVD STE 5
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3122
Practice Address - Country:US
Practice Address - Phone:760-235-9365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV40343-DI-0133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered