Provider Demographics
NPI:1295493542
Name:HUGGINS, JOSEPH BLAKE (NP)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:BLAKE
Last Name:HUGGINS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:BLAKE
Other - Last Name:BRAWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6255 W SUNSET BLVD FL 21
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7422
Mailing Address - Country:US
Mailing Address - Phone:323-860-5200
Mailing Address - Fax:323-467-7119
Practice Address - Street 1:2141 K ST NW STE 707
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1810
Practice Address - Country:US
Practice Address - Phone:202-293-8680
Practice Address - Fax:202-293-8694
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1054590363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner