Provider Demographics
NPI:1932689601
Name:NUGENT, ANNMARIE
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:
Last Name:NUGENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3326 DURHAM CHAPEL HILL BLVD STE 120B
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6246
Mailing Address - Country:US
Mailing Address - Phone:919-719-8344
Mailing Address - Fax:
Practice Address - Street 1:211 E COEUR D ALENE AVE STE 102
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4926
Practice Address - Country:US
Practice Address - Phone:208-918-3728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID8840101Y00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor