Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 1-066695 | AL |
N | 363LP2300X | Nurse Practitioner - Primary Care | 1-066695 | AL |
NPI | 1053954248 |
---|---|
Provider Name | Mrs. Kimberly Pope Hughes |
First Address | Rainsville, AL 35986-0649 |
Second Address | Rainsville, AL 35986-5254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2019 |
Last Update Date | 02/10/2020 |