Provider Demographics
NPI:1265627160
Name:HUGHES, KISHA CHRISTINE (MD)
Entity type:Individual
Prefix:MRS
First Name:KISHA
Middle Name:CHRISTINE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:280 SIERRA COLLEGE DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5763
Mailing Address - Country:US
Mailing Address - Phone:530-477-4480
Mailing Address - Fax:530-477-7755
Practice Address - Street 1:280 SIERRA COLLEGE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5763
Practice Address - Country:US
Practice Address - Phone:530-477-4480
Practice Address - Fax:530-477-7755
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GATL002790207R00000X
CAA111916207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine