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General NPI Number Information
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NPI Number | 1932514247
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Entity Type | Individual
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Provider Name | JANAE DUDGEON MD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2014
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Last Update Date | 03/08/2019
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Provider Practice Location Address
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Address Line | 2731 HEALTHCARE DR
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City | SYRACUSE
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State | NE
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Zip | 68446-7880
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Country | US
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Telephone | 402-269-2611
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Fax | 402-483-5079
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Provider Business Mailing Address
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Address Line | PO BOX N
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City | SYRACUSE
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State | NE
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Zip | 68446-0518
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Country | US
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Telephone | 402-269-2611
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Fax | 402-483-5079
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | TEP7252
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License Number State | NE
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