Provider Demographics
NPI:1194265488
Name:HUGHES, JEANNINE ANN (CNMT,RTR,RN)
Entity type:Individual
Prefix:
First Name:JEANNINE
Middle Name:ANN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:CNMT,RTR,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 DETTLING RD
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-2153
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 DETTLING RD
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754-2153
Practice Address - Country:US
Practice Address - Phone:978-793-9137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253977163W00000X
MA189404247100000X
MA023982471N0900X
MA0091402471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine Technology
No163W00000XNursing Service ProvidersRegistered Nurse
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist