Individual
CHELSIE PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 LINE AVE STE 206, SHREVEPORT, LA 71101-4649
(318) 235-3393
Mailing address
6245 DILLINGHAM AVE, SHREVEPORT, LA 71106-3303
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
226255
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/06/2022
Last updated
01/25/2024
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