Individual provider Active NPI

Kevens Duliepre, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Mineola, NY
National Provider Identifier
1093243537
Registry record updated Sep 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405077 Issued in NY
Practice address
110 Main St
Mineola, NY 11501-4000
Phone
(516) 747-5644
NPI assigned
May 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405077 NY Primary
Registered Nurse 163W00000X 730345 NY

Addresses

Primary practice location

110 Main St
Mineola, NY 11501-4000

Mailing address

198 Heathcote Rd # PVT
Elmont, NY 11003-2006
Phone (718) 807-8559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
730345NYMDRegistered Nurse
405077NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694217600000",
    "number": "1093243537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 HEATHCOTE RD # PVT",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032006",
            "telephone_number": "718-807-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014000",
            "telephone_number": "516-747-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULIEPRE",
        "first_name": "KEVENS",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-29",
        "last_updated": "2023-09-09",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405077",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "730345",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.