Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Vivian Dudley

Individual provider Nurse Practitioner · NPI 1013018654

Vivian Dudley is a Nurse Practitioner in Bourbon, Missouri. Qualified in 2000, 26 years ago. Practices with Mercy Clinic East Communities, a 573-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
26
Licensed in
MO
In the registry since
2006

Practice location Address checks out

125 N Old Hwy 66
Bourbon, MO 65441
Phone: (573) 679-2006
Fax: (573) 679-2009
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 142760 (MO)

Record details

NPI number1013018654
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 26, 2006
Last updated in NPPESAugust 25, 2014
Mailing address125 N Old Hwy 66, Bourbon, MO 65441

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Mercy Clinic East Communities — 573 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare