Theresa Pugh, RN
Registered Nurse, General Practice in Mcdonough, GA. Individual provider (NPI-1).
NPI number1942606496
StatusActive
Last updated in NPPESJun 23, 2020
Details
- NPI
- 1942606496
- Entity type
- Individual (NPI-1)
- Name
- Theresa Pugh
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 11, 2014
- Certification date
- Jun 23, 2020
- Last updated
- Jun 23, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WG0000X | Registered Nurse, General Practice | RN181879 | GA | Yes |
| 171M00000X | Case Manager/Care Coordinator | RN181879 | GA |
Practice location
155 Westridge Pkwy Ste 225Mcdonough, GA 30253-3052
Phone 678-251-9922 · Fax 678-782-5924
Mailing address
1053 Crown Landing PkwyMcdonough, GA 30252-8717
Phone 678-249-4796
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