Healthcare Provider Details

I. General information

NPI: 1104101856
Provider Name (Legal Business Name): MONICA HUGHES CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 03/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 VETERANS HWY STE 200
MILLERSVILLE MD
21108-1566
US

IV. Provider business mailing address

8601 VETERANS HWY STE 200
MILLERSVILLE MD
21108-1566
US

V. Phone/Fax

Practice location:
  • Phone: 410-729-0690
  • Fax: 410-729-4057
Mailing address:
  • Phone: 410-729-0690
  • Fax: 410-729-4057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberN32087
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberLJ-0000339
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLJ-0000339
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: