MEDICARE: DEBORAH ANN HUGHSON RNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	222528	AZ
2	363LG0600X	Gerontology Nurse Practitioner	222528	AZ
3	363LF0000X	Family Nurse Practitioner	222528	AZ

General Provider Information

NPI Number	:	1164988135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH ANN HUGHSON RNP

Provider Business Mailing Address
First Line	:	5263 HWY 95
Second Line	:
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426-9223
Country	:	US
Telephone Number	:	928-704-6400
Fax Number	:	928-768-1150

Provider Business Practice Location Address
First Line	:	5263 HWY 95
Second Line	:
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426-9223
Country	:	US
Telephone Number	:	928-704-6400
Fax Number	:	928-768-1150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2019
Last Update Date	:	02/20/2024

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