Provider Demographics
NPI:1710746227
Name:HUGHETT, KRISTY KAY
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:KAY
Last Name:HUGHETT
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 1:1012 N 31ST PL
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-2920
Mailing Address - Country:US
Mailing Address - Phone:515-571-4698
Mailing Address - Fax:
Practice Address - Street 1:500 NE 6TH ST
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:IA
Practice Address - Zip Code:50574-2204
Practice Address - Country:US
Practice Address - Phone:866-540-3858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool