Individual
ELTOYA HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1998 PATRIOT WALK DR, JACKSONVILLE, FL 32221-5614
(904) 887-0507
Mailing address
1998 PATRIOT WALK DR, JACKSONVILLE, FL 32221-5614
(904) 887-0507
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9301053
FL
251J00000X
Nursing Care Agency
Primary
—
—
310400000X
Assisted Living Facility
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
05/01/2025
Last updated
05/08/2025
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