Provider Demographics
NPI:1487672465
Name:PUGH, TAMMY LYNN (ACNP)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LYNN
Last Name:PUGH
Suffix:
Gender:F
Credentials:ACNP
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Mailing Address - Street 1:3 MOBILE INFIRMARY CIR STE 305
Mailing Address - Street 2:BUILDING B, SUITE 118
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3515
Mailing Address - Country:US
Mailing Address - Phone:251-435-7328
Mailing Address - Fax:251-433-5558
Practice Address - Street 1:3 MOBILE INFIRMARY CIR STE 305
Practice Address - Street 2:BUILDING B, SUITE 118
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3515
Practice Address - Country:US
Practice Address - Phone:251-435-7328
Practice Address - Fax:251-433-5558
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-090544363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51511597OtherBLUE CROSS
AL510I970036Medicare PIN