Provider Demographics
NPI:1760739817
Name:RAGUSA, ABIGAIL MARIE (RN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MARIE
Last Name:RAGUSA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:MARIE
Other - Last Name:VERGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:37 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-1866
Mailing Address - Country:US
Mailing Address - Phone:508-284-1134
Mailing Address - Fax:
Practice Address - Street 1:37 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-1866
Practice Address - Country:US
Practice Address - Phone:508-284-1134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN87983164W00000X
MARN2287942163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse