Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 19780 | TN |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 19780 | TN |
NPI | 1386036903 |
---|---|
Provider Name | Eddie Gene Hughes |
First Address | Johnson City, TN 37604-2277 |
Second Address | Johnson City, TN 37604-2277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2015 |
Last Update Date | 08/07/2021 |