Provider Demographics
NPI:1396021655
Name:HUGHES, DEIDRE S (RN)
Entity type:Individual
Prefix:
First Name:DEIDRE
Middle Name:S
Last Name:HUGHES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MAXWELL DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-4061
Mailing Address - Country:US
Mailing Address - Phone:518-881-0581
Mailing Address - Fax:518-881-0495
Practice Address - Street 1:35 MAXWELL DR
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-4061
Practice Address - Country:US
Practice Address - Phone:518-881-0581
Practice Address - Fax:518-881-0495
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY452954251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)