Provider Demographics
NPI:1609477942
Name:HUGHES, KEITH (PARAMEDIC)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 401
Mailing Address - Street 2:
Mailing Address - City:NEW ENGLAND
Mailing Address - State:ND
Mailing Address - Zip Code:58647-0401
Mailing Address - Country:US
Mailing Address - Phone:701-495-4507
Mailing Address - Fax:
Practice Address - Street 1:11750 HIGHWAY 21 W
Practice Address - Street 2:
Practice Address - City:NEW ENGLAND
Practice Address - State:ND
Practice Address - Zip Code:58647-9200
Practice Address - Country:US
Practice Address - Phone:701-495-4507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND129345146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic