Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP125950 | TX |
NPI | 1013323278 |
---|---|
Provider Name | Julie Nugent |
First Address | Bryan, TX 77802-6065 |
Second Address | Bryan, TX 77802-2584 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2014 |
Last Update Date | 09/07/2014 |