Provider Demographics
NPI:1578654018
Name:HUGHES, KATHLEEN MARIE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:KATHLEEN
Other - Middle Name:MARIE
Other - Last Name:CISSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9586 WHITE PILLAR TER
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20882-2815
Mailing Address - Country:US
Mailing Address - Phone:301-253-9541
Mailing Address - Fax:301-253-9541
Practice Address - Street 1:3 HARRY S TRUMAN PKWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7031
Practice Address - Country:US
Practice Address - Phone:410-222-6625
Practice Address - Fax:410-222-6679
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR107515363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health