Provider Demographics
NPI:1982772836
Name:DUPREY, JENNIFER L (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:DUPREY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 ELLIOT WAY
Mailing Address - Street 2:ELLIOT INTENSIVISTS
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3502
Mailing Address - Country:US
Mailing Address - Phone:603-663-2231
Mailing Address - Fax:603-663-2353
Practice Address - Street 1:1 ELLIOT WAY
Practice Address - Street 2:ELLIOT INTENSIVISTS
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3502
Practice Address - Country:US
Practice Address - Phone:603-663-2231
Practice Address - Fax:603-663-2353
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MET0604207R00000X
ME2039208M00000X, 207R00000X
NHLT-3192207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME433607099Medicaid
ME433607099Medicaid
ME000791103Medicare PIN