Healthcare Provider Details

I. General information

NPI: 1356791982
Provider Name (Legal Business Name): TRENTON J HUGHES APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TRENT J HUGHES FNP-C

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 15TH STREET 5TH FLOOR, MEDICAL TOWER I
MERIDIAN MS
39301
US

IV. Provider business mailing address

350 N HUMPHREYS BLVD
MEMPHIS TN
38120-2177
US

V. Phone/Fax

Practice location:
  • Phone: 601-553-6399
  • Fax: 601-703-8398
Mailing address:
  • Phone: 901-227-8693
  • Fax: 901-227-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number901551
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: