Individual
JENA PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
759 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(404) 300-2379
(404) 300-2379
Mailing address
759 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(404) 300-2379
(404) 300-2379
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN208906
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003128343C
—
GA
05
—
003128343E
—
GA
05
—
2669474
—
OH
Enumeration date
08/04/2006
Last updated
02/01/2017
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