MEDICARE: CARMEN CAVALANCIA BUGGEY CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	SP016932	PA

General Provider Information

NPI Number	:	1265976658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN CAVALANCIA BUGGEY CRNP

Provider Business Mailing Address
First Line	:	640 KOLTER DR
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3570
Country	:	US
Telephone Number	:	724-357-7196
Fax Number	:	724-357-7279

Provider Business Practice Location Address
First Line	:	188 MAIN ST
Second Line	:
City	:	PLUMVILLE
State	:	PA
Zip	:	16246-9809
Country	:	US
Telephone Number	:	724-397-9008
Fax Number	:	724-397-9015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2016
Last Update Date	:	03/12/2021

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