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Individual
MS. THERESA L DEMATTEO PUGH
Active
Individual
MS. THERESA L DEMATTEO PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R076644
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
622361300
—
MD
Enumeration date
09/22/2006
Last updated
05/09/2013
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