Provider Demographics
NPI:1881225589
Name:HUGGINS, DERONJANIQUE ONIJAY
Entity Type:Individual
Prefix:
First Name:DERONJANIQUE
Middle Name:ONIJAY
Last Name:HUGGINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3539 BURKLAND DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-7617
Mailing Address - Country:US
Mailing Address - Phone:704-963-3846
Mailing Address - Fax:
Practice Address - Street 1:3539 BURKLAND DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-7617
Practice Address - Country:US
Practice Address - Phone:704-963-3846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program