Provider Demographics
NPI:1518665983
Name:HUGIE, ELIZABETH JANINE (DNP-FNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANINE
Last Name:HUGIE
Suffix:
Gender:
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JANINE
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3535 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-3635
Mailing Address - Country:US
Mailing Address - Phone:385-430-1430
Mailing Address - Fax:
Practice Address - Street 1:1264 W VILLAGE MAIN DR UNIT A
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-1952
Practice Address - Country:US
Practice Address - Phone:801-972-0393
Practice Address - Fax:801-972-5707
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9802843-4405363LF0000X
UT9802843-3102163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT4331640Medicaid