Provider Demographics
NPI:1154817799
Name:BUGGS, TEMEKA TAYLOR
Entity Type:Individual
Prefix:MS
First Name:TEMEKA
Middle Name:TAYLOR
Last Name:BUGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 FLOWERS DR
Mailing Address - Street 2:
Mailing Address - City:BLAKELY
Mailing Address - State:GA
Mailing Address - Zip Code:39823-2810
Mailing Address - Country:US
Mailing Address - Phone:229-309-2605
Mailing Address - Fax:
Practice Address - Street 1:305 WASHINGTON ST S
Practice Address - Street 2:
Practice Address - City:FORT GAINES
Practice Address - State:GA
Practice Address - Zip Code:39851-4315
Practice Address - Country:US
Practice Address - Phone:229-768-3888
Practice Address - Fax:229-768-3889
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN171085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily