Provider Demographics
NPI:1093937989
Name:NUGENT, DEBORA LEE (RN,CNP)
Entity Type:Individual
Prefix:MS
First Name:DEBORA
Middle Name:LEE
Last Name:NUGENT
Suffix:
Gender:F
Credentials:RN,CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:S.152
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-2127
Mailing Address - Fax:612-630-8354
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:S.152
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-2127
Practice Address - Fax:612-630-8354
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR134319-2363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily