Healthcare Provider Details

I. General information

NPI: 1255370656
Provider Name (Legal Business Name): MICHELLE PAULINE HUHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 03/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 N COLLEGE ST
HUNTSVILLE AR
72740-9672
US

IV. Provider business mailing address

2400 S. 48TH STREET
SPRINGDALE AR
72762
US

V. Phone/Fax

Practice location:
  • Phone: 479-738-2878
  • Fax: 479-750-4843
Mailing address:
  • Phone: 479-750-2020
  • Fax: 479-750-4843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: