Provider Demographics
NPI:1902820574
Name:HUGHES, BERNADETTE A (MD)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:A
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10020 NICHOLAS STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2188
Mailing Address - Country:US
Mailing Address - Phone:402-393-2023
Mailing Address - Fax:402-393-3244
Practice Address - Street 1:10020 NICHOLAS STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2188
Practice Address - Country:US
Practice Address - Phone:402-393-2023
Practice Address - Fax:402-393-3244
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE192402084N0400X
NH134972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA6911545OtherMEDICAID INDIVIDUAL
NE05-00232OtherSHARE ADVANTAGE LAKESIDE
NE05-00800OtherSHARE LAKESIDE
NE05-00086OtherSHARE ADVANTAGE - BERGAN
IA1902820574Medicaid
NE8151OtherMIDLANDS CHOICE
NE01907OtherBC/BS GROUP
IA0938977OtherMEDICAID GROUP
NE05-00801OtherSHARE BERGAN
NE130022810OtherRR MEDICARE INDIVIDUAL
NE20137OtherBC/BS INDIVIDUAL
NE47054249012Medicaid
NE47054249013Medicaid
NE470542490OtherTRICARE GROUP
NECO2009OtherRR MEDICARE GROUP
NEF64926Medicare UPIN
NE094864Medicare ID - Type UnspecifiedGROUP
NE47054249012Medicaid