Provider Demographics
NPI:1710211198
Name:NUGENT, JOY DALE (NP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:DALE
Last Name:NUGENT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MEMORIAL DR
Mailing Address - Street 2:ST 2
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-1141
Mailing Address - Country:US
Mailing Address - Phone:304-329-1400
Mailing Address - Fax:304-329-1175
Practice Address - Street 1:104 FRONT STREET
Practice Address - Street 2:PRIMARY CARE CENTER, ST 2
Practice Address - City:MT MORRIS
Practice Address - State:PA
Practice Address - Zip Code:15349-0495
Practice Address - Country:US
Practice Address - Phone:724-324-9001
Practice Address - Fax:724-324-9005
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP005598B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily