Provider Demographics
NPI:1093024226
Name:HUGHES, CRYSTAL C
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:C
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 INDIAN CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3573
Mailing Address - Country:US
Mailing Address - Phone:757-436-9837
Mailing Address - Fax:
Practice Address - Street 1:328 BATTLEFIELD BLVD S
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5312
Practice Address - Country:US
Practice Address - Phone:757-482-3391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012364183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist