Healthcare Provider Details

I. General information

NPI: 1407113707
Provider Name (Legal Business Name): AMY L DUPPS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY L FORTE RN

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 04/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 4002
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE ML 4002
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4649
  • Fax: 513-636-7743
Mailing address:
  • Phone: 513-636-4649
  • Fax: 513-636-7743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN286290
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: