Provider Demographics
NPI:1437599560
Name:PUGEL, DEANNA (LCP, LMLP, RN, CCM)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:PUGEL
Suffix:
Gender:F
Credentials:LCP, LMLP, RN, CCM
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:DUBES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCP, LMLP, RN
Mailing Address - Street 1:8000 W 127TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2714
Mailing Address - Country:US
Mailing Address - Phone:913-951-4300
Mailing Address - Fax:
Practice Address - Street 1:8000 W 127TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2714
Practice Address - Country:US
Practice Address - Phone:913-951-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1385937112163W00000X
KS277103T00000X
KS0577103T00000X
MO2000171955163W00000X
KS00130177171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No163W00000XNursing Service ProvidersRegistered Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator