Provider Demographics
NPI:1710390109
Name:HUGHES, LEE M (NP)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:M
Last Name:HUGHES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:LEE
Other - Middle Name:M
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:509 SUMTER ST OFC
Mailing Address - Street 2:
Mailing Address - City:MONTEZUMA
Mailing Address - State:GA
Mailing Address - Zip Code:31063-1733
Mailing Address - Country:US
Mailing Address - Phone:478-472-3154
Mailing Address - Fax:478-472-3251
Practice Address - Street 1:502 SUMTER ST
Practice Address - Street 2:
Practice Address - City:MONTEZUMA
Practice Address - State:GA
Practice Address - Zip Code:31063-1734
Practice Address - Country:US
Practice Address - Phone:478-472-8178
Practice Address - Fax:478-472-3289
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN225465163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse