Provider Demographics
NPI:1033576574
Name:RUGG, DENISE (APRN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RUGG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RESEARCH DR
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-4312
Mailing Address - Country:US
Mailing Address - Phone:508-688-3499
Mailing Address - Fax:508-755-4791
Practice Address - Street 1:100 RESEARCH DR
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-4312
Practice Address - Country:US
Practice Address - Phone:508-688-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-27
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN178338363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health