Provider Demographics
NPI:1336193598
Name:HUGHES, ANGELA KATHRYN (FNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:KATHRYN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 W GEORGIA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-2835
Mailing Address - Country:US
Mailing Address - Phone:208-615-5515
Mailing Address - Fax:208-561-9956
Practice Address - Street 1:270 W GEORGIA AVE STE 110
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-2835
Practice Address - Country:US
Practice Address - Phone:208-615-5515
Practice Address - Fax:208-561-9956
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP805A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTQ57658Medicare UPIN