Healthcare Provider Details

I. General information

NPI: 1881149193
Provider Name (Legal Business Name): JILL K DUGAR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 07/05/2025
Certification Date: 07/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 DUPONT PKWY
TOWNSEND DE
19734-9000
US

IV. Provider business mailing address

401 ROUTE 73 N BLDG 10, SUITE 320 BLG 10, SUITE 320
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 302-449-2570
  • Fax: 302-449-2573
Mailing address:
  • Phone: 856-872-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0000364
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberLG-0000364
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: