MEDICARE: JENELLE DUGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TA0400X	Addiction (Substance Use Disorder) Psychologist	AP138130	TX
2	363LF0000X	Family Nurse Practitioner	AP138130	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841777000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENELLE DUGAN

Provider Business Mailing Address
First Line	:	PO BOX 96
Second Line	:
City	:	WAXAHACHIE
State	:	TX
Zip	:	75168-0096
Country	:	US
Telephone Number	:	214-477-8692
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 E RANDOL MILL RD STE 700
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-1410
Country	:	US
Telephone Number	:	682-746-8082
Fax Number	:	682-757-0477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2018
Last Update Date	:	10/01/2025

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Directions to “ JENELLE DUGAN ” Practice Location

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