Healthcare Provider Details

I. General information

NPI: 1386320562
Provider Name (Legal Business Name): TIANNA M HUGHES CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E SUPERIOR ST STE 301
DULUTH MN
55802-2207
US

IV. Provider business mailing address

1001 E SUPERIOR ST STE 301
DULUTH MN
55802-2207
US

V. Phone/Fax

Practice location:
  • Phone: 218-249-4700
  • Fax: 218-249-5148
Mailing address:
  • Phone: 218-249-4700
  • Fax: 218-249-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number10265
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: