=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275873820
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELODY ANN HUGHES FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2013
-----------------------------------------------------
Last Update Date | 10/20/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 933 HIGHWAY 126
-----------------------------------------------------
City | BRISTOL
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37620-3310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-844-7000
-----------------------------------------------------
Fax | 423-844-7007
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 9
-----------------------------------------------------
City | KINGSPORT
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37662-0009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-857-2066
-----------------------------------------------------
Fax | 423-857-2070
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APN0000017314
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------