Individual
JACQUELYN MARIAH BRUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2528 LAS BRISAS DR, VIRGINIA BEACH, VA 23456-4264
(757) 642-2690
Mailing address
1341 GRAHAM RD, VIRGINIA BEACH, VA 23454-2303
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001301443
VA
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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