Provider Demographics
NPI:1225285570
Name:HUGHES, PHYLLIS ANNE (PLN)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:ANNE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PLN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 W GLENN DR
Mailing Address - Street 2:SUITE 255
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-2468
Mailing Address - Country:US
Mailing Address - Phone:623-937-0225
Mailing Address - Fax:623-939-3438
Practice Address - Street 1:5800 W. GLEN DR.
Practice Address - Street 2:SUITE 255
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-2468
Practice Address - Country:US
Practice Address - Phone:623-937-0225
Practice Address - Fax:623-939-3438
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP016160164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse