Provider Demographics
NPI:1487223160
Name:HUGHES, DEANNAH OPAL (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:MISS
First Name:DEANNAH
Middle Name:OPAL
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 RESERVOIR RD LOT 414
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2967
Mailing Address - Country:US
Mailing Address - Phone:419-905-3558
Mailing Address - Fax:
Practice Address - Street 1:1800 RESERVOIR RD LOT 414
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2967
Practice Address - Country:US
Practice Address - Phone:567-702-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide