Provider Demographics
NPI:1609426923
Name:HUGHES, AMIE (BA)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 W CHUBBUCK RD
Mailing Address - Street 2:
Mailing Address - City:CHUBBUCK
Mailing Address - State:ID
Mailing Address - Zip Code:83202-2963
Mailing Address - Country:US
Mailing Address - Phone:208-251-4951
Mailing Address - Fax:
Practice Address - Street 1:4737 S AFTON PL STE A
Practice Address - Street 2:
Practice Address - City:CHUBBUCK
Practice Address - State:ID
Practice Address - Zip Code:83202-2317
Practice Address - Country:US
Practice Address - Phone:208-251-4951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist