Provider Demographics
NPI:1427728807
Name:HUQ, AUPALA SHANNON (APRN)
Entity type:Individual
Prefix:
First Name:AUPALA
Middle Name:SHANNON
Last Name:HUQ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 E CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4819
Mailing Address - Country:US
Mailing Address - Phone:859-912-1740
Mailing Address - Fax:
Practice Address - Street 1:2112 E CONCORD ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4819
Practice Address - Country:US
Practice Address - Phone:859-912-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily