Provider Demographics
NPI:1447749684
Name:HUGHES, ELLEN
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:HUGHES
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 1:11890 SUNRISE VALLEY DR STE 105
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3302
Mailing Address - Country:US
Mailing Address - Phone:703-556-8983
Mailing Address - Fax:703-556-8985
Practice Address - Street 1:11890 SUNRISE VALLEY DR STE 105
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3302
Practice Address - Country:US
Practice Address - Phone:703-556-8983
Practice Address - Fax:703-556-8985
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-1837251E00000X, 253Z00000X
385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care