Provider Demographics
NPI:1013063759
Name:MCCLUGGAGE, NANCY ANNE (CNM)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANNE
Last Name:MCCLUGGAGE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7127 CAMINO DEGRAZIA UNIT 125
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-7831
Mailing Address - Country:US
Mailing Address - Phone:858-268-4681
Mailing Address - Fax:
Practice Address - Street 1:34730 BOB WILSON DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-3100
Practice Address - Country:US
Practice Address - Phone:619-532-7295
Practice Address - Fax:619-532-6587
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANMW 782367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife