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General NPI Number Information
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NPI Number | 1679086367
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Entity Type | Organization
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Legal Business Name | HOPE NP HOUSE CALL PRACTICE
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 11/16/2017
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Provider Practice Location Address
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Address Line | 98 GRANDVIEW AVE
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City | JACKSON
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State | OH
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Zip | 45640-9090
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Country | US
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Telephone | 740-710-1306
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Fax | 866-496-6040
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Provider Business Mailing Address
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Address Line | 98 GRANDVIEW AVE
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City | JACKSON
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State | OH
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Zip | 45640-9090
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Country | US
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Telephone | 740-710-1306
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Fax | 866-496-6040
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Authorized Official
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Title or Position | CNP
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Name | KIMBERLY DAWN HUGHES
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Credential |
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Telephone | 740-710-1306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12485
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License Number State | OH
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