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General NPI Number Information
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NPI Number | 1801265053
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Entity Type | Individual
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Provider Name | DEBRA LYNN PUGH PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 2355 STATE ST STE 101
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City | SALEM
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State | OR
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Zip | 97301-4541
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Country | US
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Telephone | 253-298-1560
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Fax |
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Provider Business Mailing Address
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Address Line | 62682 E FLOWER RIDGE DR
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City | TUCSON
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State | AZ
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Zip | 85739-2194
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Country | US
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Telephone | 253-298-1560
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 201804902NP-PP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP60273070
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 255966
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License Number State | AZ
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