MEDICARE: MRS. PHYLLIS ANNE HUGHES PLN

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	164W00000X	Licensed Practical Nurse	LP016160	AZ

General Provider Information

NPI Number	:	1225285570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PHYLLIS ANNE HUGHES PLN

Provider Business Mailing Address
First Line	:	5800 W GLENN DR
Second Line	:	SUITE 255
City	:	GLENDALE
State	:	AZ
Zip	:	85301-2468
Country	:	US
Telephone Number	:	623-937-0225
Fax Number	:	623-939-3438

Provider Business Practice Location Address
First Line	:	5800 W. GLEN DR.
Second Line	:	SUITE 255
City	:	GLENDALE
State	:	AZ
Zip	:	85301-2468
Country	:	US
Telephone Number	:	623-937-0225
Fax Number	:	623-939-3438

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

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	08/19/2008

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