Healthcare Provider Details

I. General information

NPI: 1184925943
Provider Name (Legal Business Name): WENDY G PARKER HUGHES R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2010
Last Update Date: 11/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MERCANTILE LN
LARGO MD
20774-5374
US

IV. Provider business mailing address

5800 MARIETTA STATION DR
GLENN DALE MD
20769-9138
US

V. Phone/Fax

Practice location:
  • Phone: 301-618-5534
  • Fax:
Mailing address:
  • Phone: 301-404-9677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN48500
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: