Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP129358 | TX |
N | 363LA2100X | Nurse Practitioner - Acute Care | 791006 | TX |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 791006 | TX |
NPI | 1134599863 |
---|---|
Provider Name | Kailee Marie Hughes |
First Address | Arlington, TX 76014-2075 |
Second Address | Fort Worth, TX 76104-2711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2015 |
Last Update Date | 30/12/2015 |