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General NPI Number Information
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NPI Number | 1790639524
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Entity Type | Individual
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Provider Name | MAEGUN STARLETT HUMPHRIES RPSGT, CCSH
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Gender | Female
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 502 N MACARTHUR AVE STE A
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City | PANAMA CITY
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State | FL
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Zip | 32401-3666
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Country | US
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Telephone | 850-769-1797
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Fax | 850-215-2185
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Provider Business Mailing Address
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Address Line | PO BOX 760
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City | LYNN HAVEN
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State | FL
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Zip | 32444-0760
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Country | US
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Telephone | 850-832-8945
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Fax |
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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 | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State | FL
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