Provider Demographics
NPI:1124432679
Name:DUPREE, TARA LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:LYNN
Last Name:DUPREE
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 NORTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:MS
Mailing Address - Zip Code:39666-9165
Mailing Address - Country:US
Mailing Address - Phone:601-341-9933
Mailing Address - Fax:
Practice Address - Street 1:1608 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2064
Practice Address - Country:US
Practice Address - Phone:601-684-1445
Practice Address - Fax:601-684-3616
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71868183500000X
MSE088931835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist