Provider Demographics
NPI:1689073991
Name:HUGHES, JAMICA (FNP)
Entity Type:Individual
Prefix:
First Name:JAMICA
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11039 HULL STREET RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-3254
Mailing Address - Country:US
Mailing Address - Phone:804-658-3483
Mailing Address - Fax:888-628-6488
Practice Address - Street 1:11039 HULL STREET RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-3254
Practice Address - Country:US
Practice Address - Phone:804-658-3483
Practice Address - Fax:888-628-6488
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178212363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0164889765Medicaid
VAMH5508506OtherDEA
VAXH5508506OtherDEA