Individual
LISA J PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
999 BROADWAY STE 101-I, SAUGUS, MA 01906-4521
(781) 832-0035
Mailing address
999 BROADWAY STE 101-I, SAUGUS, MA 01906-4521
(781) 832-0035
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
197514
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
197514
MA
363LA2200X
Adult Health Nurse Practitioner
197514
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
197514
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0374971
—
MA
01
—
39158
HARVARD PILGRIM
MA
01
—
NP3032
BLUE CROSS
MA
Enumeration date
04/26/2006
Last updated
10/04/2024
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