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General NPI Number Information
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NPI Number | 1033835145
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Entity Type | Individual
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Provider Name | JACQUELYN RENEE DUPEE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 554 WICKHAM WAY
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City | GAHANNA
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State | OH
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Zip | 43230-2233
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Country | US
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Telephone | 567-224-0719
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 LAKESIDE AVE E STE 100
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City | CLEVELAND
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State | OH
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Zip | 44114-1172
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Country | US
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Telephone | 567-224-0719
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0031558
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License Number State | OH
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