MEDICARE: LUZIA TUGGLE NP-C

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	F0111052	KY

General Provider Information

NPI Number	:	1104123751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUZIA TUGGLE NP-C

Provider Business Mailing Address
First Line	:	2300 CONCRETE RD
Second Line	:	STE B
City	:	CARLISLE
State	:	KY
Zip	:	40311-9721
Country	:	US
Telephone Number	:	859-289-2212
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 CONCRETE RD
Second Line	:	STE B
City	:	CARLISLE
State	:	KY
Zip	:	40311-9721
Country	:	US
Telephone Number	:	859-289-2212
Fax Number	:

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

Provider Enumeration Date	:	02/17/2011
Last Update Date	:	09/20/2012

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