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General NPI Number Information
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NPI Number | 1306368501
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Entity Type | Individual
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Provider Name | JESSICA LYNN DUGGAR APRN
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Gender | Female
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 07/10/2017
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Provider Practice Location Address
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Address Line | 107 N 9TH ST
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City | OZARK
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State | AR
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Zip | 72949-2796
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Country | US
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Telephone | 479-667-2923
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Fax |
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Provider Business Mailing Address
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Address Line | 4502 LOW GAP RD
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City | OZARK
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State | AR
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Zip | 72949-9510
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Country | US
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Telephone | 479-209-4131
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Fax |
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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 | A005183
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License Number State | AR
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