MEDICARE: AMY NICHOLE HUGHES APRN, BC

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	56208	WV

General Provider Information

NPI Number	:	1508152935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY NICHOLE HUGHES APRN, BC

Provider Business Mailing Address
First Line	:	1012 TIMBERVIEW DR
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25314-2224
Country	:	US
Telephone Number	:	304-419-1211
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 CALDWELL LN
Second Line	:
City	:	DUNBAR
State	:	WV
Zip	:	25064-2026
Country	:	US
Telephone Number	:	901-261-4848
Fax Number	:	901-261-4849

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

Provider Enumeration Date	:	06/23/2011
Last Update Date	:	10/15/2013

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