Provider Demographics
NPI:1790857134
Name:HUGHES, LINDA G (NP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:G
Last Name:HUGHES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:HUGHES
Other - Last Name:BARDOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-262-1405
Mailing Address - Fax:
Practice Address - Street 1:12493 UNIVERSITY AVE
Practice Address - Street 2:STE 110
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8286
Practice Address - Country:US
Practice Address - Phone:515-358-9400
Practice Address - Fax:515-358-9420
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-114344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA151AC1083OtherIOWA DRIVERS LICENSE