Provider Demographics
NPI:1902107683
Name:HUGGINS, KEESHA NICOLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KEESHA
Middle Name:NICOLE
Last Name:HUGGINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 NIAGARA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-7885
Mailing Address - Country:US
Mailing Address - Phone:419-382-0324
Mailing Address - Fax:419-382-0324
Practice Address - Street 1:536 NIAGARA AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-7885
Practice Address - Country:US
Practice Address - Phone:419-382-0324
Practice Address - Fax:419-382-0324
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH328047163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse