Provider Demographics
NPI:1316762636
Name:DUPREE, LACAROL MONAE (RN)
Entity type:Individual
Prefix:
First Name:LACAROL
Middle Name:MONAE
Last Name:DUPREE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LACAROL
Other - Middle Name:MONAE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:289 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29010-1513
Mailing Address - Country:US
Mailing Address - Phone:803-484-5972
Mailing Address - Fax:
Practice Address - Street 1:289 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BISHOPVILLE
Practice Address - State:SC
Practice Address - Zip Code:29010-1513
Practice Address - Country:US
Practice Address - Phone:803-484-5972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC214767163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse