Provider Demographics
NPI:1225860588
Name:PUGLIESE, REBECCA (RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:PUGLIESE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11474 E 27TH PL
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85367-8921
Mailing Address - Country:US
Mailing Address - Phone:928-920-2000
Mailing Address - Fax:
Practice Address - Street 1:450 W 6TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-2973
Practice Address - Country:US
Practice Address - Phone:928-920-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ270174163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool