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NPI Code Detail

MEDICARE: KRISTINA LYNN HUFFMAN PAC

MEDICARE: KRISTINA LYNN HUFFMAN PAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant50001950OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11057200OTHERNCCPA
250001950OTHEROHSTATE MEDICAL BOARD

General Provider Information

NPI Number : 1740258342
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA LYNN HUFFMAN PAC
Provider Business Mailing Address
First Line : 5735 MEEKER RD
Second Line :
City : GREENVILLE
State : OH
Zip : 45331-1180
Country : US
Telephone Number : 937-548-9680
Fax Number : 937-548-2087
Provider Business Practice Location Address
First Line : 5735 MEEKER RD
Second Line :
City : GREENVILLE
State : OH
Zip : 45331-1180
Country : US
Telephone Number : 937-548-9680
Fax Number : 937-548-2087
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 07/29/2014

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Directions to “ KRISTINA LYNN HUFFMAN PAC” Practice Location

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