Healthcare Provider Details

I. General information

NPI: 1508152935
Provider Name (Legal Business Name): AMY NICHOLE HUGHES APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 CALDWELL LN
DUNBAR WV
25064-2026
US

IV. Provider business mailing address

1012 TIMBERVIEW DR
CHARLESTON WV
25314-2224
US

V. Phone/Fax

Practice location:
  • Phone: 901-261-4848
  • Fax: 901-261-4849
Mailing address:
  • Phone: 304-419-1211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number56208
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: