Provider Demographics
NPI:1265976658
Name:BUGGEY, CARMEN CAVALANCIA (CRNP)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:CAVALANCIA
Last Name:BUGGEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 KOLTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3570
Mailing Address - Country:US
Mailing Address - Phone:724-357-7196
Mailing Address - Fax:724-357-7279
Practice Address - Street 1:188 MAIN ST
Practice Address - Street 2:
Practice Address - City:PLUMVILLE
Practice Address - State:PA
Practice Address - Zip Code:16246-9809
Practice Address - Country:US
Practice Address - Phone:724-397-9008
Practice Address - Fax:724-397-9015
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily