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General NPI Number Information
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NPI Number | 1699666842
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Entity Type | Individual
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Provider Name | CARA JEAN PUGH
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Gender |
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 156 LAING AVENUE
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City | ECCLES
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State | WV
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Zip | 25836
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Country | US
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Telephone | 304-237-4956
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 238
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City | ECCLES
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State | WV
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Zip | 25836-0238
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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