Healthcare Provider Details

I. General information

NPI: 1790617256
Provider Name (Legal Business Name): KEVIN HUGHES RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 742
HIGLEY AZ
85236-0742
US

IV. Provider business mailing address

PO BOX 742
HIGLEY AZ
85236-0742
US

V. Phone/Fax

Practice location:
  • Phone: 602-377-6933
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN167081
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: