Provider Demographics
NPI:1679224414
Name:HUGHES, PATRICIA ASHLEY-SUSETTE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ASHLEY-SUSETTE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 PIERRE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-1109
Mailing Address - Country:US
Mailing Address - Phone:469-585-2744
Mailing Address - Fax:
Practice Address - Street 1:4715 PIERRE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-1109
Practice Address - Country:US
Practice Address - Phone:469-585-2744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO5819OtherDOULA
5819OtherDOULA