Individual
JACLYN YVETTE PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
700 DOCTORS CT, LEESBURG, FL 34748-7314
(352) 787-9838
(352) 787-8705
Mailing address
700 DOCTORS CT, LEESBURG, FL 34748-7314
(352) 787-9838
(352) 787-8705
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9253579
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007291900
—
FL
01
—
Y0J2Q
FL BLUE (BCBS)
FL
Enumeration date
11/30/2012
Last updated
01/06/2025
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