Individual
MRS. KELLY NICOLE HUGHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 PATEWOOD DR STE B400, GREENVILLE, SC 29615-6306
(864) 454-4368
(864) 241-9232
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2084
SC
363AS0400X
Surgical Physician Assistant
2084
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1898PA
—
SC
01
—
D400031008
MEDICARE
CT
Enumeration date
09/10/2010
Last updated
08/10/2023
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