Doctor Name: | LAQUITTA HUGHES |
NPI Number: | 1104216381 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | A004347 |
Business Practice Address: | 5375 Savannah Pkwy Southaven, MS - 386727516 |
Business Phone Number: | 6019412410 |
Business Fax Number: | |
Mailing Address: | 5375 Savannah Pkwy, SOUTHAVEN |
State: | MS |
Postal Code: | 386727516 |
Phone Number: | 6019412410 |
Fax Number: | |
NPI Enumeration Date: | 01/27/2015 |
NPI Last Update Date: | 03/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A004347 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |