Provider Demographics
NPI:1740617174
Name:HUGHES, LISA R (PNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3501 BELLEVUE AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-3504
Mailing Address - Country:US
Mailing Address - Phone:908-489-2112
Mailing Address - Fax:
Practice Address - Street 1:8733 BEVERLY BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1827
Practice Address - Country:US
Practice Address - Phone:310-652-3981
Practice Address - Fax:310-652-3906
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2017-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA23629363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics