Provider Demographics
NPI:1356015192
Name:HUGULEY, LATOYA RENEE (APRN)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:RENEE
Last Name:HUGULEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:78284 DUCKWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-0650
Mailing Address - Country:US
Mailing Address - Phone:912-674-4517
Mailing Address - Fax:
Practice Address - Street 1:10175 FORTUNE PKWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6746
Practice Address - Country:US
Practice Address - Phone:904-610-3393
Practice Address - Fax:904-544-3827
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine