Healthcare Provider Details

I. General information

NPI: 1346992120
Provider Name (Legal Business Name): ABIGAIL NOLIE DUGGER APRN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2022
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 COOPER ST
FORT WORTH TX
76104-2710
US

IV. Provider business mailing address

PO BOX 733784
DALLAS TX
75373-3784
US

V. Phone/Fax

Practice location:
  • Phone: 682-885-1202
  • Fax: 682-885-1204
Mailing address:
  • Phone: 682-885-6163
  • Fax: 682-885-6121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1062195
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: