Provider Demographics
NPI:1043501307
Name:GACUGA, GLADWELL W (NP)
Entity Type:Individual
Prefix:
First Name:GLADWELL
Middle Name:W
Last Name:GACUGA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 SPRINGSWEET LN
Mailing Address - Street 2:APT 15
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-7163
Mailing Address - Country:US
Mailing Address - Phone:507-398-9533
Mailing Address - Fax:
Practice Address - Street 1:DUKE UNIVERSITY DEPT OF ADVANCED CLINICAL
Practice Address - Street 2:BOX 3677
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005157363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health