Healthcare Provider Details

I. General information

NPI: 1245705326
Provider Name (Legal Business Name): MS. ANITRA HUGHES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 TIDEWATER DR STE 19
NORFOLK VA
23505-3700
US

IV. Provider business mailing address

7525 TIDEWATER DR STE 19
NORFOLK VA
23505-3700
US

V. Phone/Fax

Practice location:
  • Phone: 757-330-0150
  • Fax: 877-487-3044
Mailing address:
  • Phone: 757-330-0150
  • Fax: 877-487-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5011213
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number195251
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number0024184455
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: