Provider Demographics
NPI:1497370191
Name:SHUGART, KAREN (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:SHUGART
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 LEWISVILLE CLEMMONS RD STE E
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-7460
Mailing Address - Country:US
Mailing Address - Phone:336-766-0505
Mailing Address - Fax:336-277-6981
Practice Address - Street 1:2255 LEWISVILLE CLEMMONS RD STE E
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-7460
Practice Address - Country:US
Practice Address - Phone:336-766-0505
Practice Address - Fax:336-277-6981
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013227363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health