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Individual

COURTNEY ANN NUGENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3641
Mailing address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3641

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.147598
OH
208000000X
Pediatrics Physician
4351045099
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
35.147598
OH LICENSE
OH
01
4351045099
LIMITED EDUCATION LICENSE
MI
01
5315207204
CONTROLLED SUBSTANCE LICENSE
MI
Enumeration date
05/30/2019
Last updated
06/26/2023
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