Healthcare Provider Details

I. General information

NPI: 1760824189
Provider Name (Legal Business Name): DEBORAH JEAN DUGAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 06/16/2024
Certification Date: 06/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 E LINDRICK DR
GILBERT AZ
85298-7422
US

IV. Provider business mailing address

2102 E LINDRICK DR
GILBERT AZ
85298-7422
US

V. Phone/Fax

Practice location:
  • Phone: 480-516-5644
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN094396
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberRN094396
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP5067
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: