Individual
MRS. DIEDRA SHANEL HUGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
333 FOUNDRY STREET, NEW MARTINSVILLE, WV 26155
(304) 455-2441
Mailing address
50 SANTEE RUN ROAD, HUNDRED, WV 26575
(304) 775-4153
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
57567
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427238583
—
WV
Enumeration date
09/02/2018
Last updated
09/02/2018
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