MS. ROXANNE D. DUDLEY


Address: 1011 College Ave, Jacksonville, TX 75766-3307
Phone: 9035899000

MS. ROXANNE D. DUDLEY (NPI# 1922244904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922244904
Entity Type Individual
Full Name MS. ROXANNE D. DUDLEY
Credential RN, PMHNP-BC, LPC
Practice Address 1011 College Ave
Jacksonville
TX 75766-3307
Practice Telephone 9035899000
Mailing Telephone (512) 573-8026
Enumeration Date 2008-12-23
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101Y00000X Counselor 62107 TX Behavioral Health & Social Service Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
AP134786 TX Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX 1268237-08 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
1405 S Fleishel Ave, Suite #332, Tyler, TX 757013345 5125738026
3320 S Loop 256, Palestine, TX 758016984 9037236136

Office Location

Street Address 1011 COLLEGE AVE
City JACKSONVILLE
State TX
Zip Code 75766-3307

Providers in the same location

NPI Name Taxonomy Address Enumeration
1265560767 Anderson Cherokee Community Enrichment Services Counselor 1011 College Ave, Jacksonville, TX 75766 2007-02-28
1932707882 Emily Fisher Counselor 1011 College Ave, Jacksonville, TX 75766-3307 2020-10-13
1336773613 Joyce Loretta Caldwell Counselor 1011 College Ave, Jacksonville, TX 75766-3307 2020-02-26
1710540562 Dennis Raymond Steelman Counselor 1011 College Ave, Jacksonville, TX 75766-3307 2019-04-17
1104399047 Donna K Daigle-thomas Counselor 1011 College Ave, Jacksonville, TX 75766-3307 2019-01-03
1245710227 Donna Lee Faulkner Counselor 1011 College Ave, Jacksonville, TX 75766-3307 2018-08-18
1255822151 Mabel N. Nwachukwu Nurse Practitioner 1011 College Ave, Jacksonville, TX 75766-3307 2018-05-25
1710412838 Sarah E Tunnell Counselor 1011 College Ave, Jacksonville, TX 75766-3307 2017-04-26
1467835090 Kaila Sue Rice Counselor 1011 College Ave, Jacksonville, TX 75766-3307 2015-07-01
1710015201 Anderson Cherokee Community Enrichment Services Counselor 1011 College Ave, Jacksonville, TX 75766 2007-02-28
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770062788 David Rentz Occupational Therapy Assistant 838 Brown St., Jacksonville, TX 75766 2018-08-09
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1164703047 Aegis Psychological Consulting LLC Psychologist 208 E. Rusk St., Jacksonville, TX 75766 2011-09-06
1952697872 Melissa Springmeyer Family Medicine 2026 South Jacksonville Street, Jacksonville, TX 75766 2011-06-20
1306031018 Michael Kay Moore Occupational Therapist 4155 Cr 3908, Jacksonville, TX 75766 2007-09-06
1730398827 Cherokee County Health Department Public Health or Welfare 510 East Commerce, Jacksonville, TX 75766 2007-05-22
1568689545 Mary Alice Bone Preventive Medicine 510 E. Commerce, Jacksonville, TX 75766 2007-04-19
1619093176 Assisted Living Concepts Inc Assisted Living Facility 211 Phillip Street, Jacksonville, TX 75766 2007-03-22
1881776912 Mark Allan Thompson Dentist 701 S Main, Jacksonville, TX 75766 2006-10-19
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City JACKSONVILLE
Zip Code 75766

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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