MEDICARE: JACQUELYNN DORMAN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician	AP140013	TX
2	363LF0000X	Family Nurse Practitioner	AP140013	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962068981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELYNN DORMAN FNP

Provider Business Mailing Address
First Line	:	6509 MOSSWOOD DR
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79707-5075
Country	:	US
Telephone Number	:	432-978-3022
Fax Number	:	432-614-0876

Provider Business Practice Location Address
First Line	:	1330 E 8TH ST STE 414
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79761-4733
Country	:	US
Telephone Number	:	432-614-2176
Fax Number	:	432-614-0876

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2019
Last Update Date	:	03/21/2025

Similar Medicare Providers

1811990088 — DR. PAMELA A MCQUILLIN M.D.
Practice Location Address:

1330 E 8TH ST STE 420
ODESSA, TX
79761-4733

Practice Phone: 432-580-9191
Practice Fax: 949-862-7691

1699776567 — ODYSSEY HEALTHCARE OPERATING A LP
Practice Location Address:

1330 EAST 8TH STREET , SUITE 410
ODESSA, TX
79761-4733

Practice Phone: 432-552-1400
Practice Fax: 432-333-3702

1437379245 — PAMELA A. MCQUILLIN, M.D., P.A.
Practice Location Address:

1330 E 8TH ST STE 420
ODESSA, TX
79761-4733

Practice Phone: 432-580-9191
Practice Fax: 432-332-1344

1205625720 — LIZBETH JIMENEZ MA. LPC
Practice Location Address:

1406 N GRANDVIEW AVE
ODESSA, TX
79761-3140

Practice Phone: 432-220-3273
Practice Fax:

1659154458 — KRYSTEN RENTERIA
Practice Location Address:

405 N TOM GREEN AVE
ODESSA, TX
79761-5145

Practice Phone: 432-580-8976
Practice Fax:

1215930649 — DR. JOSEPH KEVIN DOWDEN M.D.
Practice Location Address:

520 E 6TH ST
ODESSA, TX
79761-4527

Practice Phone: 432-582-8467
Practice Fax:

Directions to “ JACQUELYNN DORMAN FNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.