Active NPI
Kevens Duliepre, RN
- Psychiatric/Mental Health Nurse Practitioner
- Mineola, NY
National Provider Identifier
1093243537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 405077
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 730345 | NY | MD | Registered Nurse |
| 405077 | NY | MD | Psychiatric/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.