Provider Demographics
NPI:1336150275
Name:PUGSLEY, BRENDA ANN (APRN)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:ANN
Last Name:PUGSLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 NEIL RD
Mailing Address - Street 2:#207
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6556
Mailing Address - Country:US
Mailing Address - Phone:775-398-1981
Mailing Address - Fax:775-398-1984
Practice Address - Street 1:5250 NEIL RD.
Practice Address - Street 2:#207
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6556
Practice Address - Country:US
Practice Address - Phone:775-398-1981
Practice Address - Fax:775-398-1984
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN00491363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002416067Medicaid
NVV34225Medicare ID - Type Unspecified
NVS89426Medicare UPIN