Healthcare Provider Details

I. General information

NPI: 1477239226
Provider Name (Legal Business Name): DEANA PAUGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 HURFFVILLE - CROSS KEYS RD
SEWELL NJ
08080
US

IV. Provider business mailing address

424 PENNSYLVANIA AVE
PROSPECT PARK PA
19076-1616
US

V. Phone/Fax

Practice location:
  • Phone: 856-434-2940
  • Fax:
Mailing address:
  • Phone: 610-842-2827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP027652
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ14905500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: