Provider Demographics
NPI:1013026947
Name:HUGHEY, TONYA C (CFNP)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:C
Last Name:HUGHEY
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 BROOKWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601-2644
Mailing Address - Country:US
Mailing Address - Phone:601-823-5000
Mailing Address - Fax:601-823-4140
Practice Address - Street 1:940 BROOKWAY BLVD
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-2644
Practice Address - Country:US
Practice Address - Phone:601-823-5000
Practice Address - Fax:601-823-4140
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR850440363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00123105Medicaid
MS500000713Medicare ID - Type Unspecified
P15202Medicare UPIN