Healthcare Provider Details

I. General information

NPI: 1154344190
Provider Name (Legal Business Name): JULIETTE EVELYN HUGHES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 03/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 B 12TH AVE RD
NAMPA ID
83686
US

IV. Provider business mailing address

1611 B 12TH AVE RD
NAMPA ID
83686
US

V. Phone/Fax

Practice location:
  • Phone: 208-442-8035
  • Fax: 208-442-8038
Mailing address:
  • Phone: 208-442-8035
  • Fax: 208-442-8038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberM8055
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: