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General NPI Number Information
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NPI Number | 1588477608
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Entity Type | Individual
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Provider Name | STACEY DUPREE MICHAEL DNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 14089 ABERCORN ST
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City | SAVANNAH
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State | GA
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Zip | 31419-1966
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Country | US
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Telephone | 912-777-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 CARVER ST
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City | SAVANNAH
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State | GA
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Zip | 31415-5296
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Country | US
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Telephone | 912-604-2226
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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 | RN132307
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License Number State | GA
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