Healthcare Provider Details

I. General information

NPI: 1093042541
Provider Name (Legal Business Name): KRISTEN ELIZABETH HUGHES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTEN ELIZABETH MUSSELMAN

II. Dates (important events)

Enumeration Date: 11/04/2009
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6325 HUMPHREYS BLVD
MEMPHIS TN
38120-2300
US

IV. Provider business mailing address

6325 HUMPHREYS BLVD
MEMPHIS TN
38120-2300
US

V. Phone/Fax

Practice location:
  • Phone: 901-522-7700
  • Fax: 901-522-2600
Mailing address:
  • Phone: 901-522-7700
  • Fax: 901-522-2600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00856
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA-1354
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number012811
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085004193
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number085004193
License Number StateIL
# 6
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5345
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: