Individual
DANIELLE PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
208 KEY DR STE C, MADISON, MS 39110-7378
(601) 760-2050
(601) 207-7707
Mailing address
208 KEY DR STE C, MADISON, MS 39110-7378
(601) 357-1821
(601) 207-7707
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
903630
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN11004972
FL
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
903630
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639718455
NPI
—
Enumeration date
12/26/2019
Last updated
03/21/2025
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