Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 002257 | CT |
NPI | 1013947621 |
---|---|
Provider Name | Monica Hughes |
First Address | Wolcott, CT 06716-2107 |
Second Address | Waterbury, CT 06706-1113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004204591 | (05) | CT |
P04798 | (02) | CT |