Provider Demographics
NPI:1609551282
Name:ELLIS-HUGHES, JONI A (RN, BSN, CCRN, CRNI)
Entity Type:Individual
Prefix:MRS
First Name:JONI
Middle Name:A
Last Name:ELLIS-HUGHES
Suffix:
Gender:F
Credentials:RN, BSN, CCRN, CRNI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 UNIVERSITY BLVD S STE 125
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4375
Mailing Address - Country:US
Mailing Address - Phone:904-683-4355
Mailing Address - Fax:904-475-2706
Practice Address - Street 1:3901 UNIVERSITY BLVD S STE 125
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4375
Practice Address - Country:US
Practice Address - Phone:904-683-4355
Practice Address - Fax:904-475-2706
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1898382163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1851848006Medicaid