Provider Demographics
NPI:1922855774
Name:HUGHES, JACQUELINE AMBER (NP)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:AMBER
Last Name:HUGHES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 NEW VISTAS CT NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-0704
Mailing Address - Country:US
Mailing Address - Phone:505-280-9888
Mailing Address - Fax:
Practice Address - Street 1:4801 MCMAHON BLVD NW STE 101
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5090
Practice Address - Country:US
Practice Address - Phone:505-893-2840
Practice Address - Fax:505-893-2844
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM78555363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner