Provider Demographics
NPI:1215578364
Name:HUGHES, SAMANTHA R (FNP, RN)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:R
Last Name:HUGHES
Suffix:
Gender:F
Credentials:FNP, RN
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:R
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10031 NEW HOPE CT
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-2875
Mailing Address - Country:US
Mailing Address - Phone:757-232-1261
Mailing Address - Fax:
Practice Address - Street 1:209 VILLAGE AVE STE P
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-5639
Practice Address - Country:US
Practice Address - Phone:757-316-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily