NPI 1063196079 · live from the CMS NPI Registry
Annie Dupre, RDN, LDN
Dietitian, Registered in Wakefield, RI. National Provider Identifier 1063196079, active.
NPI record
| NPI | 1063196079 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 29 Cleveland St Apt 3, Wakefield, RI 02879 |
| Practice phone | 401-585-6305 |
| Enumerated | June 12, 2023 |
| Last updated | August 20, 2026 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | LDN6632 (MA) |
| Dietitian, Registered | 133V00000X | LDN1409 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.