MEDICARE: ADRIA DUPLESSIS NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	AP137461	TX
2	363LP2300X	Primary Care Nurse Practitioner	AP137461	TX

General Provider Information

NPI Number	:	1891284642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIA DUPLESSIS NP-C

Provider Business Mailing Address
First Line	:	6736 VERDE APT 163
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-3422
Country	:	US
Telephone Number	:	214-433-7036
Fax Number	:

Provider Business Practice Location Address
First Line	:	2308 LAKE FOREST DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76708-1121
Country	:	US
Telephone Number	:	214-970-0762
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2018
Last Update Date	:	03/05/2020

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