Provider Demographics
NPI:1447789144
Name:HUGHES, ALEXIS (RD, LD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PLANT AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-3040
Mailing Address - Country:US
Mailing Address - Phone:618-207-4366
Mailing Address - Fax:
Practice Address - Street 1:5 PLANT AVE STE 2
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-3025
Practice Address - Country:US
Practice Address - Phone:618-363-9409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013030174133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered