Provider Demographics
NPI:1336771963
Name:HUGHES, NAKEISHA N
Entity Type:Individual
Prefix:
First Name:NAKEISHA
Middle Name:N
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 1:351 CHAPARRAL RD APT 1404
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4174
Mailing Address - Country:US
Mailing Address - Phone:937-389-7657
Mailing Address - Fax:
Practice Address - Street 1:351 CHAPARRAL RD APT 1404
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-4174
Practice Address - Country:US
Practice Address - Phone:937-389-7657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0082526251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0082526Medicaid