Provider Demographics
NPI:1316567910
Name:HUGHLEY, ALICIA
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:
Last Name:HUGHLEY
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 1:6439 PLYMOUTH AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63133-1940
Mailing Address - Country:US
Mailing Address - Phone:314-337-2590
Mailing Address - Fax:
Practice Address - Street 1:2947 SANTIAGO DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-2616
Practice Address - Country:US
Practice Address - Phone:314-269-4154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health