Provider Demographics
NPI:1114580701
Name:NUGENT, MARTHA LEIGH (APRN, AGNP-C)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:LEIGH
Last Name:NUGENT
Suffix:
Gender:
Credentials:APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1624
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:MT
Mailing Address - Zip Code:59270-1624
Mailing Address - Country:US
Mailing Address - Phone:406-519-3446
Mailing Address - Fax:406-401-0144
Practice Address - Street 1:813 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:MT
Practice Address - Zip Code:59270-4940
Practice Address - Country:US
Practice Address - Phone:406-519-3446
Practice Address - Fax:406-401-0144
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR52997363LG0600X
MTNUR-APRN-LIC-149639363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology