Basic Information
Provider Information
NPI: 1528205432
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUGHES
FirstName: LESLIE
MiddleName: ANN
NamePrefix: MS.
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 235022
Address2:  
City: MONTGOMERY
State: AL
PostalCode: 361235022
CountryCode: US
TelephoneNumber: 3343862055
FaxNumber: 3343966929
Practice Location
Address1: 470 TAYLOR RD
Address2: TAYLOR MEDICAL COMPLEX
City: MONTGOMERY
State: AL
PostalCode: 361173563
CountryCode: US
TelephoneNumber: 3342849600
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/14/2009
LastUpdateDate: 01/14/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X1-100343ALY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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