MEDICARE: MRS. NEDRA LATOYA HUGHES NP-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	198782	GA

General Provider Information

NPI Number	:	1811315948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NEDRA LATOYA HUGHES NP-C

Provider Business Mailing Address
First Line	:	9276 COLLINWOOD DR
Second Line	:
City	:	MIDLAND
State	:	GA
Zip	:	31820-4278
Country	:	US
Telephone Number	:	706-332-5965
Fax Number	:

Provider Business Practice Location Address
First Line	:	1810 STADIUM DR STE 210
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-3179
Country	:	US
Telephone Number	:	334-291-5255
Fax Number	:

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

Provider Enumeration Date	:	04/05/2014
Last Update Date	:	04/05/2014

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