Provider Demographics
NPI:1285044537
Name:HUGHES, MARY BETH (RN)
Entity Type:Individual
Prefix:MS
First Name:MARY BETH
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:MARY BETH
Other - Middle Name:
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3750 FAR HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2506
Mailing Address - Country:US
Mailing Address - Phone:937-499-1430
Mailing Address - Fax:937-499-1465
Practice Address - Street 1:3090 GLENGARRY DR
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45420-1227
Practice Address - Country:US
Practice Address - Phone:937-499-1720
Practice Address - Fax:937-499-1739
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN223311163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse