Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 2004R | NM |
NPI | 1174134423 |
---|---|
Provider Name | Prof. Jessie Marie Hughes |
First Address | Ranchos De Taos, NM 87557-1194 |
Second Address | Ranchos De Taos, NM 87557-8714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2020 |
Last Update Date | 11/08/2020 |