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General NPI Number Information
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NPI Number | 1205410230
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Entity Type | Individual
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Provider Name | DANA S DUDLEY NP
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Gender | Female
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 222 UNIVERSITY PKWY
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City | AIKEN
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State | SC
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Zip | 29801-6310
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Country | US
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Telephone | 803-306-1438
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Fax |
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Provider Business Mailing Address
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Address Line | 3696 WHEELER RD
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City | AUGUSTA
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State | GA
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Zip | 30909-6520
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Country | US
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Telephone | 706-736-1830
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Fax | 706-650-7553
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 000194
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 24948
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License Number State | SC
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