Provider Demographics
NPI:1447709423
Name:RUGH, DONNA L (MSN, RN-BC,CHPN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:RUGH
Suffix:
Gender:F
Credentials:MSN, RN-BC,CHPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 E PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:ALDAN
Mailing Address - State:PA
Mailing Address - Zip Code:19018-4127
Mailing Address - Country:US
Mailing Address - Phone:484-337-3366
Mailing Address - Fax:
Practice Address - Street 1:130 S BRYN MAWR AVE
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3121
Practice Address - Country:US
Practice Address - Phone:484-337-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-01
Last Update Date:2016-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN563753163WH1000X, 163WP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WP0000XNursing Service ProvidersRegistered NursePain Management