Provider Demographics
NPI:1861487282
Name:HUGHES, LYNDA J (FNP APN)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:J
Last Name:HUGHES
Suffix:
Gender:F
Credentials:FNP APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 PARR AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-2073
Mailing Address - Country:US
Mailing Address - Phone:731-288-3375
Mailing Address - Fax:731-288-3379
Practice Address - Street 1:1716 PARR AVE STE B
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024
Practice Address - Country:US
Practice Address - Phone:731-288-3375
Practice Address - Fax:731-288-3379
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN95592363L00000X
TNAPN6814363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3349830Medicaid
TN4070681OtherBLUE CROSS
P00082456OtherPALMETTO GBA
27779OtherTLC MEMPHIS MANAGED CARE
146178OtherBETTER HEALTH PLAN
TN4070681OtherBLUE CROSS
P98237Medicare UPIN