Provider Demographics
NPI:1134599863
Name:HUGHES, KAILEE MARIE (APRN)
Entity type:Individual
Prefix:
First Name:KAILEE
Middle Name:MARIE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KAILEE
Other - Middle Name:MARIE
Other - Last Name:RABINOVITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:601 OMEGA DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2075
Mailing Address - Country:US
Mailing Address - Phone:817-465-5881
Mailing Address - Fax:817-394-6294
Practice Address - Street 1:1521 COOPER ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2711
Practice Address - Country:US
Practice Address - Phone:817-336-5864
Practice Address - Fax:817-336-2159
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX791006363LA2100X, 363LC0200X
TXAP129358363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine