Healthcare Provider Details

I. General information

NPI: 1386017689
Provider Name (Legal Business Name): AMANDA CAROLINE DUPREE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA CAROLINE DUPREE

II. Dates (important events)

Enumeration Date: 11/09/2015
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE # M-917
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

6520 FORT CAROLINE RD
JACKSONVILLE FL
32277-2044
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1116
  • Fax:
Mailing address:
  • Phone: 904-745-3618
  • Fax: 904-722-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberNP95039522
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9465865
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN620968
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9465865
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP015616
License Number StatePA
# 6
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberNP95039522
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP9465865
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: