Healthcare Provider Details

I. General information

NPI: 1821145814
Provider Name (Legal Business Name): ELIZABETH HUGHES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 JEFFERSON AVE. MCDONALD ARMY HEALTH CENTER
FORT EUSTIS VA
23604-5548
US

IV. Provider business mailing address

3 LILLIAN CT
HAMPTON VA
23669-1825
US

V. Phone/Fax

Practice location:
  • Phone: 757-878-1358
  • Fax: 757-878-1370
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number0001068627
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: