Healthcare Provider Details

I. General information

NPI: 1215592464
Provider Name (Legal Business Name): LAUREN HUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8060 COUNTS MASSIE RD STE B
MAUMELLE AR
72113-6657
US

IV. Provider business mailing address

164 SANDY FORD RD
BEEBE AR
72012-9731
US

V. Phone/Fax

Practice location:
  • Phone: 501-492-0099
  • Fax:
Mailing address:
  • Phone: 870-761-7566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA005674
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: