Healthcare Provider Details

I. General information

NPI: 1326079047
Provider Name (Legal Business Name): KATHERINE W HUGHES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 TYLER HOLMES DR
WINONA MS
38967-1521
US

IV. Provider business mailing address

409 TYLER HOLMES DR
WINONA MS
38967-1521
US

V. Phone/Fax

Practice location:
  • Phone: 662-283-4114
  • Fax:
Mailing address:
  • Phone: 662-283-4114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR853701
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: