Provider Demographics
NPI:1972678472
Name:HUGHES, LORI A (PA-C)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-373-1222
Mailing Address - Fax:269-373-6270
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-373-1222
Practice Address - Fax:269-373-6270
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601003941363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1972678472Medicaid
MI1972678472Medicaid
MIC97618250Medicare PIN
MIC97618250 - BMHMedicare PIN