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NPI Code Detail

MEDICARE: MRS. ROBERTA JUNE HUGHES APN

MEDICARE: MRS. ROBERTA JUNE HUGHES APN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner209-003524IL
2363LF0000XFamily Nurse Practitioner309.001726IL

General Provider Information

NPI Number : 1740329374
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROBERTA JUNE HUGHES APN
Provider Business Mailing Address
First Line : 448 WYLIE DR
Second Line :
City : NORMAL
State : IL
Zip : 61761-5405
Country : US
Telephone Number : 309-820-3535
Fax Number : 309-451-7761
Provider Business Practice Location Address
First Line : 50 NORTHGATE INDUSTRIAL DR
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-6805
Country : US
Telephone Number : 618-877-4420
Fax Number : 618-877-9526
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 11/14/2019

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