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General NPI Number Information
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NPI Number | 1245256262
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Entity Type | Individual
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Provider Name | SHELLY L. HUCKABY RN, FNP
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Gender | Female
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 18230 FM 1488 RD STE 200
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City | MAGNOLIA
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State | TX
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Zip | 77354-4530
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Country | US
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Telephone | 936-270-4800
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Fax | 936-270-4801
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Provider Business Mailing Address
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Address Line | 18230 FM 1488 RD STE 200
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City | MAGNOLIA
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State | TX
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Zip | 77354-4530
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Country | US
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Telephone | 936-270-4800
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Fax | 936-270-4801
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 669836
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP114965
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License Number State | TX
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