Provider Demographics
NPI:1528437407
Name:HUGHES, AMBER NACOLE
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NACOLE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:PADISETTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP FNP
Mailing Address - Street 1:1053 E 60TH ST APT 937
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-8327
Mailing Address - Country:US
Mailing Address - Phone:918-907-2129
Mailing Address - Fax:
Practice Address - Street 1:9175 S YALE AVE STE 220
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4043
Practice Address - Country:US
Practice Address - Phone:918-884-7800
Practice Address - Fax:918-731-4518
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK70047363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily