Individual
LATRISHA RENAY DUPREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
707 SAINT CLAIR AVE, BELLEVILLE, IL 62220-2319
(618) 363-3421
Mailing address
707 SAINT CLAIR AVE, BELLEVILLE, IL 62220-2319
(618) 363-3421
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2016021966
MO
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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