Provider Demographics
NPI:1093490351
Name:HUGHES, KAI BOWEN (RN, MSN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KAI
Middle Name:BOWEN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:RN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:KAI
Other - Middle Name:ASHLEY
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 BRIARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HAZLEHURST
Mailing Address - State:GA
Mailing Address - Zip Code:31539-8070
Mailing Address - Country:US
Mailing Address - Phone:912-253-0648
Mailing Address - Fax:912-699-6443
Practice Address - Street 1:163 S TALLAHASSEE ST
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:GA
Practice Address - Zip Code:31539-6465
Practice Address - Country:US
Practice Address - Phone:912-699-6441
Practice Address - Fax:912-699-6441
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN230419363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner