Doctor Name: | JESSICA S DUGAN |
NPI Number: | 1316091093 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ITDS |
License Number: | |
Business Practice Address: | 111 Nature Walk Parkway Suite 101 St Augustine, FL - 32092 |
Business Phone Number: | 9042307761 |
Business Fax Number: | 9042307763 |
Mailing Address: | 4813 Innisbrook Ct S, ELKTON |
State: | FL |
Postal Code: | 320332067 |
Phone Number: | 9042307761 |
Fax Number: | 9042307763 |
NPI Enumeration Date: | 01/22/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |