Provider Demographics
NPI:1376392993
Name:PUGH, NADIA ANN (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:ANN
Last Name:PUGH
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 SE 19TH LN
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-4539
Mailing Address - Country:US
Mailing Address - Phone:239-276-9423
Mailing Address - Fax:
Practice Address - Street 1:1104 SE 19TH LN
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-4539
Practice Address - Country:US
Practice Address - Phone:239-276-9423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND8809133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered