Healthcare Provider Details

I. General information

NPI: 1801616586
Provider Name (Legal Business Name): SHERRY ANN HUFF NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 GRIFFON RD UNIT 102
VERO BEACH FL
32966-2549
US

IV. Provider business mailing address

2080 GRIFFON RD UNIT 102
VERO BEACH FL
32966-2549
US

V. Phone/Fax

Practice location:
  • Phone: 417-576-2147
  • Fax:
Mailing address:
  • Phone: 417-576-2147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11036001
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: