Provider Demographics
NPI:1982162269
Name:HUGHES, STEDMAN EMANUEL (FNP)
Entity Type:Individual
Prefix:MR
First Name:STEDMAN
Middle Name:EMANUEL
Last Name:HUGHES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:MR
Other - First Name:STEDMAN
Other - Middle Name:EMANUEL
Other - Last Name:HUGHES
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9669 LINDEN BROOK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1120
Mailing Address - Country:US
Mailing Address - Phone:937-270-9558
Mailing Address - Fax:
Practice Address - Street 1:5971 GOLF CLUB LN
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-8225
Practice Address - Country:US
Practice Address - Phone:513-896-3000
Practice Address - Fax:513-737-0524
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH024079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty