Provider Demographics
NPI:1740251131
Name:HUGHES, REBECCA S (CRNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:HUGHES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 E MIDLOTHIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44507
Mailing Address - Country:US
Mailing Address - Phone:330-788-6506
Mailing Address - Fax:330-788-7805
Practice Address - Street 1:77 E MIDLOTHIAN BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507
Practice Address - Country:US
Practice Address - Phone:330-788-2487
Practice Address - Fax:330-788-7805
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH276038163WW0101X
OH05974363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0007754Medicaid
P34854Medicare UPIN
OH0007754Medicaid