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General NPI Number Information
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NPI Number | 1194530402
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Entity Type | Individual
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Provider Name | PHILLIP RICHARD DUPREY-HENRY LPN, NREMT-P
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Gender | Male
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 825 N CENTER AVE
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City | GAYLORD
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State | MI
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Zip | 49735-1592
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Country | US
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Telephone | 989-731-2131
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Fax |
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Provider Business Mailing Address
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Address Line | 6577 ELLEN DR
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City | ROSCOMMON
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State | MI
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Zip | 48653-7171
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Country | US
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Telephone |
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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 | 146L00000X
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Taxonomy Name | Paramedic
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License Number | M5080373
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 4703128668
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License Number State | MI
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