Healthcare Provider Details

I. General information

NPI: 1942649660
Provider Name (Legal Business Name): BETH LYNN HUGHES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2013
Last Update Date: 06/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 W FRONT ST
IVA SC
29655-8702
US

IV. Provider business mailing address

235 MCADAMS SCHOOL RD
HONEA PATH SC
29654-9591
US

V. Phone/Fax

Practice location:
  • Phone: 864-348-6196
  • Fax:
Mailing address:
  • Phone: 864-369-7951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number41589
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number41589
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: