Provider Demographics
NPI:1104394246
Name:HUGHES, LEAH (APRN)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9203
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-9203
Mailing Address - Country:US
Mailing Address - Phone:502-895-9627
Mailing Address - Fax:502-895-8977
Practice Address - Street 1:3950 KRESGE WAY STE 308
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4637
Practice Address - Country:US
Practice Address - Phone:502-895-8911
Practice Address - Fax:502-895-8977
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1131646163W00000X
KY3013238363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse