Provider Demographics
NPI:1326571159
Name:HUGHES, CAROL (DNP APRN FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:DNP APRN FNP-BC
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 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:
Practice Address - Street 1:1503 MAIN ST
Practice Address - Street 2:
Practice Address - City:DES ARC
Practice Address - State:AR
Practice Address - Zip Code:72040-3299
Practice Address - Country:US
Practice Address - Phone:870-256-4178
Practice Address - Fax:870-256-4085
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-08
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017001676363LF0000X
AR10204908363LF0000X
ARA005079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR220598758Medicaid