MEDICARE: MS. SHAVONDRA HUGGINS WHNP-BC, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	ARNP9198927	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124263256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHAVONDRA HUGGINS WHNP-BC, FNP-C

Provider Business Mailing Address
First Line	:	9560 CROSSHILL BLVD
Second Line	:	SUITE 110
City	:	JACKSONVILLE
State	:	FL
Zip	:	32222-5827
Country	:	US
Telephone Number	:	904-308-7792
Fax Number	:	904-779-7335

Provider Business Practice Location Address
First Line	:	9560 CROSSHILL BLVD
Second Line	:	SUITE 110
City	:	JACKSONVILLE
State	:	FL
Zip	:	32222-5827
Country	:	US
Telephone Number	:	904-308-7792
Fax Number	:	904-779-7335

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	05/22/2014

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Directions to “ MS. SHAVONDRA HUGGINS WHNP-BC, FNP-C” Practice Location

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