Provider Demographics
NPI:1922300581
Name:HUGHES, DAWNA L (PCA)
Entity Type:Individual
Prefix:MS
First Name:DAWNA
Middle Name:L
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:MS
Other - First Name:DAWNA
Other - Middle Name:L
Other - Last Name:SHEARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PCA
Mailing Address - Street 1:121 N BEECH ST
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-1711
Mailing Address - Country:US
Mailing Address - Phone:937-733-4004
Mailing Address - Fax:
Practice Address - Street 1:121 N BEECH ST
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-1711
Practice Address - Country:US
Practice Address - Phone:937-733-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3720932805923747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH372093280592OtherOHIO CERTIFICATION - PCA/CERTIFIED NURSE AIDE
OH3065516Medicaid