Healthcare Provider Details

I. General information

NPI: 1124455191
Provider Name (Legal Business Name): ELIZABETH HUGHES CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 BURNBRAE RD
TOWSON MD
21204-4212
US

IV. Provider business mailing address

15 BURNBRAE RD
TOWSON MD
21204-4212
US

V. Phone/Fax

Practice location:
  • Phone: 443-844-4886
  • Fax:
Mailing address:
  • Phone: 443-844-4886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR170600
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR170600
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: