Provider Demographics
NPI:1306485875
Name:HUGHES, BRIANNA SHEA (PAC)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:SHEA
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:SHEA
Other - Last Name:HINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:3400 OLD MILTON PKWY STE A410
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-3761
Mailing Address - Country:US
Mailing Address - Phone:770-225-1874
Mailing Address - Fax:678-254-0618
Practice Address - Street 1:3400 OLD MILTON PKWY STE A410
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3761
Practice Address - Country:US
Practice Address - Phone:770-225-1874
Practice Address - Fax:678-254-0618
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9834363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program