Provider Demographics
NPI:1215908637
Name:HUGHES, BRENNA LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:BRENNA
Middle Name:LYNNE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BRENNA
Other - Middle Name:LYNNE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2608 ERWIN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4596
Mailing Address - Country:US
Mailing Address - Phone:919-668-0755
Mailing Address - Fax:
Practice Address - Street 1:2608 ERWIN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4596
Practice Address - Country:US
Practice Address - Phone:919-668-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD074318L174400000X
MA227861207VM0101X
RIMD12160207VM0101X
NC2016-02015207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH86531Medicare UPIN