Provider Demographics
NPI:1760433122
Name:HUGHES, ANNE THERESE (MSN FNP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:THERESE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MSN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 E ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-1943
Mailing Address - Country:US
Mailing Address - Phone:231-933-0911
Mailing Address - Fax:
Practice Address - Street 1:3189 LOGAN VALLEY RD
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4772
Practice Address - Country:US
Practice Address - Phone:231-932-1988
Practice Address - Fax:231-932-7693
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704121941363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI518714510Medicaid
MI518714510Medicaid