Provider Demographics
NPI:1881455475
Name:DUPRE, SOPHIA ANN (FNP-C)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:ANN
Last Name:DUPRE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3843 STAGG AVE
Mailing Address - Street 2:
Mailing Address - City:BASILE
Mailing Address - State:LA
Mailing Address - Zip Code:70515-5501
Mailing Address - Country:US
Mailing Address - Phone:318-668-5927
Mailing Address - Fax:
Practice Address - Street 1:3843 STAGG AVE
Practice Address - Street 2:
Practice Address - City:BASILE
Practice Address - State:LA
Practice Address - Zip Code:70515-5501
Practice Address - Country:US
Practice Address - Phone:337-668-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-19
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA234267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily