Healthcare Provider Details

I. General information

NPI: 1679963607
Provider Name (Legal Business Name): DANA ELIZABETH HUGHES APRN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANA E TISDALE APRN

II. Dates (important events)

Enumeration Date: 01/29/2015
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10216 TAYLORSVILLE RD SUITE 400
JEFFERSONTOWN KY
40299-3616
US

IV. Provider business mailing address

2700 STANLEY GAULT PKWY SUITE 129
LOUISVILLE KY
40223-5132
US

V. Phone/Fax

Practice location:
  • Phone: 502-267-5456
  • Fax: 502-267-5488
Mailing address:
  • Phone: 502-489-5730
  • Fax: 502-489-5753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3009192
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: