Provider Demographics
NPI:1154344190
Name:HUGHES, JULIETTE EVELYN (MD)
Entity type:Individual
Prefix:DR
First Name:JULIETTE
Middle Name:EVELYN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 B 12TH AVE RD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686
Mailing Address - Country:US
Mailing Address - Phone:208-442-8035
Mailing Address - Fax:208-442-8038
Practice Address - Street 1:1611 B 12TH AVE RD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686
Practice Address - Country:US
Practice Address - Phone:208-442-8035
Practice Address - Fax:208-442-8038
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM8055207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID00001050081OtherBLUE SHIELD
ID73882OtherBLUE CROSS
ID806339500Medicaid
ID806339500Medicaid
H48941Medicare UPIN