MEDICARE: SANDRA HUGHES FNP-C

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	363LF0000X	Family Nurse Practitioner	10664658-4405	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386051407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA HUGHES FNP-C

Provider Business Mailing Address
First Line	:	312 TIMBER LAKES EST
Second Line	:
City	:	HEBER CITY
State	:	UT
Zip	:	84032-9705
Country	:	US
Telephone Number	:	508-667-0262
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 TIMBER LAKES EST
Second Line	:
City	:	HEBER CITY
State	:	UT
Zip	:	84032-9705
Country	:	US
Telephone Number	:	508-667-0262
Fax Number	:

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

Provider Enumeration Date	:	07/21/2014
Last Update Date	:	01/30/2019

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