Provider Demographics
NPI:1568103257
Name:BUGAJSKI, KRISTINE MICHELLE (RPSGT CCSH)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MICHELLE
Last Name:BUGAJSKI
Suffix:
Gender:F
Credentials:RPSGT CCSH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 W CHINABERRY CT
Mailing Address - Street 2:
Mailing Address - City:MOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27028-5174
Mailing Address - Country:US
Mailing Address - Phone:336-793-7965
Mailing Address - Fax:336-936-9481
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-998-2810
Practice Address - Fax:336-716-6979
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1203174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator