Individual
MS. ROXANNE D. DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PMHNP-BC, LPC
Contact information
Practice address
1011 COLLEGE AVE, JACKSONVILLE, TX 75766-3307
(903) 589-9000
Mailing address
1011 COLLEGE AVE, JACKSONVILLE, TX 75766-3307
(512) 573-8026
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
62107
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP134786
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1268237-08
—
TX
Enumeration date
12/23/2008
Last updated
07/21/2022
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