MEDICARE: ELLEN HUGHES

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	251E00000X	Home Health Agency	HCO-1837	VA
2	253Z00000X	In Home Supportive Care Agency	HCO-1837	VA
3	385H00000X	Respite Care

General Provider Information

NPI Number	:	1447749684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN HUGHES

Provider Business Mailing Address
First Line	:	11890 SUNRISE VALLEY DR STE 105
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-3302
Country	:	US
Telephone Number	:	703-556-8983
Fax Number	:	703-556-8985

Provider Business Practice Location Address
First Line	:	11890 SUNRISE VALLEY DR STE 105
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-3302
Country	:	US
Telephone Number	:	703-556-8983
Fax Number	:	703-556-8985

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

Provider Enumeration Date	:	05/03/2018
Last Update Date	:	05/23/2019

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Directions to “ ELLEN HUGHES ” Practice Location

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