Healthcare Provider Details

I. General information

NPI: 1912817388
Provider Name (Legal Business Name): LYNETTE MARIE HUGHS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11910 60TH ST NE
OTSEGO MN
55301
US

IV. Provider business mailing address

11910 60TH ST NE
OTSEGO MN
55301
US

V. Phone/Fax

Practice location:
  • Phone: 651-797-5159
  • Fax: 651-202-4482
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number115924
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: