Provider Demographics
NPI:1609558055
Name:DUPRE, KATELYN A (PMHNP)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:A
Last Name:DUPRE
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5594 WOODVIEW LN
Mailing Address - Street 2:
Mailing Address - City:JARREAU
Mailing Address - State:LA
Mailing Address - Zip Code:70749
Mailing Address - Country:US
Mailing Address - Phone:225-354-9207
Mailing Address - Fax:
Practice Address - Street 1:230 ROBERTS DR STE H
Practice Address - Street 2:
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760-2661
Practice Address - Country:US
Practice Address - Phone:225-618-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA231772363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health