Healthcare Provider Details

I. General information

NPI: 1518762202
Provider Name (Legal Business Name): LAURA FERNANDA HUGHES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 PIPPIN PL NE
ROME GA
30165-9158
US

IV. Provider business mailing address

11 PIPPIN PL NE
ROME GA
30165-9158
US

V. Phone/Fax

Practice location:
  • Phone: 706-266-5096
  • Fax:
Mailing address:
  • Phone: 706-266-5096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number260494
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number260494
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: