Provider Demographics
NPI:1932803798
Name:HUGGINS, EMERALD JR (DNP, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:EMERALD
Middle Name:
Last Name:HUGGINS
Suffix:JR
Gender:M
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4643 N 12TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-4081
Mailing Address - Country:US
Mailing Address - Phone:602-641-4251
Mailing Address - Fax:
Practice Address - Street 1:4643 N 12TH ST STE 102
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4081
Practice Address - Country:US
Practice Address - Phone:602-641-4251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ289705363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty