Healthcare Provider Details

I. General information

NPI: 1154554053
Provider Name (Legal Business Name): JULIE A HUGHES FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 03/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SOUTHGATE SUITE 9
PENDLETON OR
97801-3974
US

IV. Provider business mailing address

1103 NW HORN AVE
PENDLETON OR
97801-1251
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-6916
  • Fax:
Mailing address:
  • Phone: 541-278-8007
  • Fax: 541-278-8007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number082010512N1 FNP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: