Provider Demographics
NPI:1972562080
Name:SUGG, LUCY SCHMIDT (CRNA)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:SCHMIDT
Last Name:SUGG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LUCY
Other - Middle Name:
Other - Last Name:HITCHMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:2295 TOWNE LAKE PKWY
Mailing Address - Street 2:STE 116-295
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-5520
Mailing Address - Country:US
Mailing Address - Phone:678-699-3636
Mailing Address - Fax:941-358-9818
Practice Address - Street 1:2001 PROFESSIONAL WAY
Practice Address - Street 2:SUITE 270
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-6442
Practice Address - Country:US
Practice Address - Phone:770-926-5459
Practice Address - Fax:770-926-9321
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28250114A367500000X
GARN045112367500000X
WAAP60765744367500000X
NC006165367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000571271Medicaid
GA000571271Medicaid