Healthcare Provider Details

I. General information

NPI: 1275397507
Provider Name (Legal Business Name): MELANIE LINTON HUGHES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 HALL ST
WIGGINS MS
39577-2107
US

IV. Provider business mailing address

1926 CARNES RD
BROOKLYN MS
39425-9002
US

V. Phone/Fax

Practice location:
  • Phone: 601-528-9119
  • Fax:
Mailing address:
  • Phone: 601-408-5897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number906510
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number906510
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: