Healthcare Provider Details

I. General information

NPI: 1033227939
Provider Name (Legal Business Name): JOANNA M HUFF APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 MILTON AVE
ALPHARETTA GA
30009-1508
US

IV. Provider business mailing address

1078 COLONY DR
ALPHARETTA GA
30009-3117
US

V. Phone/Fax

Practice location:
  • Phone: 425-449-1571
  • Fax:
Mailing address:
  • Phone: 425-449-1571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN145506
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: