Provider Demographics
NPI:1528771458
Name:PEUGH, JOSHUA DOUGLAS (FNP-C)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DOUGLAS
Last Name:PEUGH
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 S HILL ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4842
Mailing Address - Country:US
Mailing Address - Phone:770-228-1181
Mailing Address - Fax:770-228-1182
Practice Address - Street 1:822 S HILL ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4842
Practice Address - Country:US
Practice Address - Phone:770-228-1181
Practice Address - Fax:770-228-1182
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN263916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily