MEDICARE: BRITTANY DIANE HUGHES FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	193078	WI
2	363L00000X	Nurse Practitioner	11562	MN
3	363LF0000X	Family Nurse Practitioner	8891-33	WI

General Provider Information

NPI Number	:	1285119214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY DIANE HUGHES FNP-C

Provider Business Mailing Address
First Line	:	1125 BROADWAY ST N STE 3
Second Line	:
City	:	MENOMONIE
State	:	WI
Zip	:	54751-1579
Country	:	US
Telephone Number	:	920-496-4700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1125 BROADWAY ST N STE 3
Second Line	:
City	:	MENOMONIE
State	:	WI
Zip	:	54751-1579
Country	:	US
Telephone Number	:	920-496-4700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2018
Last Update Date	:	06/25/2024

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