Healthcare Provider Details

I. General information

NPI: 1821748799
Provider Name (Legal Business Name): KIARA HUFF CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 GREEN ST SE UNIT 741
CONYERS GA
30012-5511
US

IV. Provider business mailing address

1007 GREEN ST SE UNIT 741
CONYERS GA
30012-5511
US

V. Phone/Fax

Practice location:
  • Phone: 762-215-5689
  • Fax:
Mailing address:
  • Phone: 762-215-5689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: