Healthcare Provider Details

I. General information

NPI: 1538787247
Provider Name (Legal Business Name): STEPHANIE DUPRE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7557 DANNAHER DR STE 230
POWELL TN
37849-3563
US

IV. Provider business mailing address

10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US

V. Phone/Fax

Practice location:
  • Phone: 865-938-5222
  • Fax:
Mailing address:
  • Phone: 866-681-2335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000031696
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number214402
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: