Provider Demographics
NPI:1922872274
Name:HUGHES, NIKKI
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 S OREM BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-3006
Mailing Address - Country:US
Mailing Address - Phone:801-225-4911
Mailing Address - Fax:801-225-4854
Practice Address - Street 1:121 S OREM BLVD STE 103
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-3006
Practice Address - Country:US
Practice Address - Phone:801-225-4911
Practice Address - Fax:801-225-4854
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10069868-3102163W00000X
UT10069868-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse