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Individual

MISS ANSLEY PUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2939 W EXCURSION LN, MERIDIAN, ID 83642-5308
(870) 265-0298
Mailing address
1923 19TH AVE S, NASHVILLE, TN 37212-3805
(870) 265-0298

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
67375
ID

Other

Enumeration date
02/24/2021
Last updated
02/24/2021
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