Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | ARNP9374504 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9374504 | FL |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APRN9374504 | FL |
N | 363LP2300X | Nurse Practitioner - Primary Care | ARNP9374504 | FL |
NPI | 1780122317 |
---|---|
Provider Name | Shaquan Chambliss-Huggins |
First Address | Cutler Bay, FL 33190-1003 |
Second Address | Cutler Bay, FL 33190-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2017 |
Last Update Date | 25/06/2020 |