Provider Demographics
NPI:1477959930
Name:DUGGER, NICOLETTE (RN)
Entity Type:Individual
Prefix:MISS
First Name:NICOLETTE
Middle Name:
Last Name:DUGGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 HUMMINGBIRD ST
Mailing Address - Street 2:
Mailing Address - City:ELIDA
Mailing Address - State:OH
Mailing Address - Zip Code:45807-1343
Mailing Address - Country:US
Mailing Address - Phone:419-236-1559
Mailing Address - Fax:
Practice Address - Street 1:3003 HUMMINGBIRD ST
Practice Address - Street 2:
Practice Address - City:ELIDA
Practice Address - State:OH
Practice Address - Zip Code:45807-1343
Practice Address - Country:US
Practice Address - Phone:419-236-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN. 406481163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice