Healthcare Provider Details

I. General information

NPI: 1265940589
Provider Name (Legal Business Name): MICHAL NAOMI HUGGINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 POE AVE
DAYTON OH
45414-2559
US

IV. Provider business mailing address

7301 POE AVE
DAYTON OH
45414-2559
US

V. Phone/Fax

Practice location:
  • Phone: 937-280-4631
  • Fax: 937-280-4630
Mailing address:
  • Phone: 937-280-4631
  • Fax: 937-280-4630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.441500
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: