Provider Demographics
NPI:1538501085
Name:BRUGMAN, SUE ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:ANN
Last Name:BRUGMAN
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:PO BOX 246
Mailing Address - Street 2:310 MAIN STREET
Mailing Address - City:ROYAL
Mailing Address - State:IA
Mailing Address - Zip Code:51357-0246
Mailing Address - Country:US
Mailing Address - Phone:712-933-2727
Mailing Address - Fax:712-933-2724
Practice Address - Street 1:310 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROYAL
Practice Address - State:IA
Practice Address - Zip Code:51357-7607
Practice Address - Country:US
Practice Address - Phone:712-933-2727
Practice Address - Fax:712-933-2724
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-053063363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily