Provider Demographics
NPI:1790362069
Name:PUGH, DEBRA L (RN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:L
Last Name:PUGH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BUILDING 2245, 58TH STREET & 761ST BATTALION AVE
Mailing Address - Street 2:
Mailing Address - City:FT. HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-553-2300
Mailing Address - Fax:254-553-8471
Practice Address - Street 1:BUILDING 2245, 58TH STREET & 761ST BATTALION AVE
Practice Address - Street 2:
Practice Address - City:FT. HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-553-2300
Practice Address - Fax:254-553-8471
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX574496163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management