Provider Demographics
NPI:1326598996
Name:HUGULEY, CHARITY (CNA)
Entity Type:Individual
Prefix:MRS
First Name:CHARITY
Middle Name:
Last Name:HUGULEY
Suffix:
Gender:F
Credentials:CNA
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 515
Mailing Address - Street 2:
Mailing Address - City:SIMLA
Mailing Address - State:CO
Mailing Address - Zip Code:80835-0515
Mailing Address - Country:US
Mailing Address - Phone:719-310-9634
Mailing Address - Fax:
Practice Address - Street 1:431 PUEBLO AVE
Practice Address - Street 2:
Practice Address - City:SIMLA
Practice Address - State:CO
Practice Address - Zip Code:80835-0515
Practice Address - Country:US
Practice Address - Phone:719-310-9634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health