1861487282 NPI number — LYNDA J HUGHES FNP APN

Table of content: LYNDA J HUGHES FNP APN (NPI 1861487282)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861487282 NPI number — LYNDA J HUGHES FNP APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGHES
Provider First Name:
LYNDA
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861487282
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1716 PARR AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DYERSBURG
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38024-2073
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
731-288-3375
Provider Business Mailing Address Fax Number:
731-288-3379

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1716 PARR AVE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DYERSBURG
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-288-3375
Provider Business Practice Location Address Fax Number:
731-288-3379
Provider Enumeration Date:
09/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  RN95592 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: APN6814 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3349830 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4070681 . This is a "BLUE CROSS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: P00082456 . This is a "PALMETTO GBA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 27779 . This is a "TLC MEMPHIS MANAGED CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 146178 . This is a "BETTER HEALTH PLAN" identifier . This identifiers is of the category "OTHER".




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