=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669549689
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATE B DUPRE PHD APRN CS BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2006
-----------------------------------------------------
Last Update Date | 10/04/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17 W END AVE
-----------------------------------------------------
City | MIDDLEBORO
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-872-7543
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 592 HUMPHREY ST
-----------------------------------------------------
City | SWAMPSCOTT
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01907-2655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-947-8551
-----------------------------------------------------
Fax | 508-947-8521
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 91975
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------