Individual
THERESA PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN181879
GA
171M00000X
Case Manager/Care Coordinator
RN181879
GA
Other
Enumeration date
11/11/2014
Last updated
06/23/2020
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