Healthcare Provider Details

I. General information

NPI: 1245910058
Provider Name (Legal Business Name): AMBER HUGHSON CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 GOLF COURSE RD SE STE E
RIO RANCHO NM
87124-1628
US

IV. Provider business mailing address

1695 DOMAIN LOOP SE
RIO RANCHO NM
87124-2840
US

V. Phone/Fax

Practice location:
  • Phone: 505-630-2050
  • Fax: 505-581-3241
Mailing address:
  • Phone:
  • Fax: 505-581-3241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53759
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: