Provider Demographics
NPI:1467073940
Name:HUGHES, CRESHAWNDA MARRIE
Entity Type:Individual
Prefix:MS
First Name:CRESHAWNDA
Middle Name:MARRIE
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 1:1817 TONAWANDA AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2928
Mailing Address - Country:US
Mailing Address - Phone:330-958-6374
Mailing Address - Fax:
Practice Address - Street 1:1817 TONAWANDA AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2928
Practice Address - Country:US
Practice Address - Phone:330-958-6374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0000Medicaid