Healthcare Provider Details

I. General information

NPI: 1225118029
Provider Name (Legal Business Name): NANCY ANNE RUGO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HALL STREET
CONCORD NH
03301-2547
US

IV. Provider business mailing address

8945 LINDANTE DR
WHITTIER CA
90603-1023
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-7600
  • Fax: 603-228-7320
Mailing address:
  • Phone: 508-641-5639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number050575-21
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number050575-23-05
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number050575-23-04
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95005527
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95108536
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: