Provider Demographics
NPI:1295209641
Name:HYGHES, LINA
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:HYGHES
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 1:107 STANDARD WAREHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:LUGOFF
Mailing Address - State:SC
Mailing Address - Zip Code:29078-9670
Mailing Address - Country:US
Mailing Address - Phone:803-408-1197
Mailing Address - Fax:803-408-1198
Practice Address - Street 1:107 STANDARD WAREHOUSE RD
Practice Address - Street 2:
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078-9670
Practice Address - Country:US
Practice Address - Phone:803-408-1197
Practice Address - Fax:803-408-1198
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC73614163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health