Provider Demographics
NPI:1235467572
Name:PUGH, WHITNEY HARLOW (NP)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:HARLOW
Last Name:PUGH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 BOONES MILL RD
Mailing Address - Street 2:
Mailing Address - City:BOONES MILL
Mailing Address - State:VA
Mailing Address - Zip Code:24065-4318
Mailing Address - Country:US
Mailing Address - Phone:540-484-3500
Mailing Address - Fax:
Practice Address - Street 1:2727 ELECTRIC RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3540
Practice Address - Country:US
Practice Address - Phone:540-529-5692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168537363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily