Provider Demographics
NPI:1497128029
Name:HUGHES, GRACE SIMONE (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:SIMONE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:MISS
Other - First Name:GRACE
Other - Middle Name:SIMONE
Other - Last Name:LOCKLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:14940 FORWARD PASS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-0917
Mailing Address - Country:US
Mailing Address - Phone:815-997-9493
Mailing Address - Fax:
Practice Address - Street 1:7940 FLOYD CURL DR STE 1050
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3906
Practice Address - Country:US
Practice Address - Phone:210-616-5385
Practice Address - Fax:210-647-1012
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129359363LF0000X
TX823154163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX385895303Medicaid