Provider Demographics
NPI:1033450499
Name:GURGANUS, NANCY HOPE I (ANP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:HOPE
Last Name:GURGANUS
Suffix:I
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 JONES AVE
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-1514
Mailing Address - Country:US
Mailing Address - Phone:252-728-3252
Mailing Address - Fax:252-728-3251
Practice Address - Street 1:301 JONES AVE
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516-1514
Practice Address - Country:US
Practice Address - Phone:252-728-3252
Practice Address - Fax:252-728-3251
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC175990363L00000X
NC5006123363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC31364OtherLICENSE NUMBER
NC31364OtherLICENSE NUMBER