Provider Demographics
NPI:1750048963
Name:DUGI, TRACEY ANN (APRN)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:ANN
Last Name:DUGI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 LEGACY WAY
Mailing Address - Street 2:
Mailing Address - City:LA VERNIA
Mailing Address - State:TX
Mailing Address - Zip Code:78121-5689
Mailing Address - Country:US
Mailing Address - Phone:830-534-8117
Mailing Address - Fax:
Practice Address - Street 1:108 LEGACY WAY
Practice Address - Street 2:
Practice Address - City:LA VERNIA
Practice Address - State:TX
Practice Address - Zip Code:78121-5689
Practice Address - Country:US
Practice Address - Phone:830-534-8117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059138363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal