Healthcare Provider Details

I. General information

NPI: 1184681702
Provider Name (Legal Business Name): STEPHANIE D HUFF CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US

IV. Provider business mailing address

PO BOX 4283
OPELIKA AL
36803-4283
US

V. Phone/Fax

Practice location:
  • Phone: 334-528-1112
  • Fax: 334-528-1547
Mailing address:
  • Phone: 334-528-1112
  • Fax: 334-528-1547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-080061
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: