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General NPI Number Information
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NPI Number | 1932447604
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Entity Type | Individual
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Provider Name | CALI DUDGEON P.A.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 11430 N PORT WASHINGTON RD
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City | MEQUON
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State | WI
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Zip | 53092-3414
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Country | US
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Telephone | 262-518-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 11430 N PORT WASHINGTON RD
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City | MEQUON
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State | WI
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Zip | 53092-3414
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Country | US
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Telephone | 262-518-1900
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 22644875
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA09910
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5906-23
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License Number State | WI
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