Provider Demographics
NPI:1336495183
Name:HUGHES, KATELYN MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:MARIE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:26825 HOPKINS RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:WI
Mailing Address - Zip Code:54893-9014
Mailing Address - Country:US
Mailing Address - Phone:320-260-4560
Mailing Address - Fax:
Practice Address - Street 1:26825 HOPKINS RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:WI
Practice Address - Zip Code:54893-9014
Practice Address - Country:US
Practice Address - Phone:320-260-4560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI316144-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse