Basic Information
Provider Information
NPI: 1275154452
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUGHES
FirstName: LAUREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19756 SW 93RD LANE RD
Address2:  
City: DUNNELLON
State: FL
PostalCode: 344324119
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1805 SE LAKE WEIR AVE STE B
Address2:  
City: OCALA
State: FL
PostalCode: 344715426
CountryCode: US
TelephoneNumber: 3528679601
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/29/2020
LastUpdateDate: 05/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LG0600XAPRN11006571FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
363LA2200XAPRN11006571FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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