Provider Demographics
NPI:1912786971
Name:SHUGART, HAYLEY (APRN)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:SHUGART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4624 N HUNT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-3539
Mailing Address - Country:US
Mailing Address - Phone:919-741-1140
Mailing Address - Fax:
Practice Address - Street 1:4624 N HUNT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-3539
Practice Address - Country:US
Practice Address - Phone:919-741-1140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10010540363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care