Provider Demographics
NPI:1013323278
Name:NUGENT, JULIE (ACNPC-AG)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:NUGENT
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 DRAYCOTT CT
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-6065
Mailing Address - Country:US
Mailing Address - Phone:979-229-7536
Mailing Address - Fax:
Practice Address - Street 1:2215 E VILLA MARIA RD
Practice Address - Street 2:SUITE 110
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2584
Practice Address - Country:US
Practice Address - Phone:979-776-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125950363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care