Provider Demographics
NPI:1225118029
Name:RUGO, NANCY ANNE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANNE
Last Name:RUGO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8945 LINDANTE DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-1023
Mailing Address - Country:US
Mailing Address - Phone:508-641-5639
Mailing Address - Fax:
Practice Address - Street 1:81 HALL STREET
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2547
Practice Address - Country:US
Practice Address - Phone:603-228-7600
Practice Address - Fax:603-228-7320
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH050575-21163W00000X
NH050575-23-05363LA2200X
NH050575-23-04363LW0102X
CA95005527363L00000X
CA95108536163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH40Y004551NH04OtherANTHEM, GRANTHAM LOCATION
NH4755582OtherCIGNA
NH40Y004551NH03OtherANTHEM, CONCORD LOCATION
NH30342284Medicaid
NHUX0392Medicare PIN
NH40Y004551NH03OtherANTHEM, CONCORD LOCATION
NP4003Medicare ID - Type Unspecified