Healthcare Provider Details

I. General information

NPI: 1417448978
Provider Name (Legal Business Name): MRS. DOROTHY ANN HUGHES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2018
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 RIDGEWOOD CENTER DR
WOODBRIDGE VA
22192-5307
US

IV. Provider business mailing address

4308 RIDGEWOOD CENTER DR
WOODBRIDGE VA
22192-5307
US

V. Phone/Fax

Practice location:
  • Phone: 571-285-3353
  • Fax: 703-763-3615
Mailing address:
  • Phone: 571-285-3353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: