Healthcare Provider Details

I. General information

NPI: 1831403989
Provider Name (Legal Business Name): KATHLEEN HUGHES CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2010
Last Update Date: 07/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE M-31
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

5474 OLIVE AVE
NORTH RIDGEVILLE OH
44039-1822
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-2408
  • Fax:
Mailing address:
  • Phone: 440-327-9998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number11472-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: