Healthcare Provider Details

I. General information

NPI: 1538911573
Provider Name (Legal Business Name): HUFFMAN HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2024
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 W LIMESTONE WAY
FORTVILLE IN
46040-1394
US

IV. Provider business mailing address

1205 W LIMESTONE WAY
FORTVILLE IN
46040-1394
US

V. Phone/Fax

Practice location:
  • Phone: 317-850-3929
  • Fax:
Mailing address:
  • Phone: 317-505-1747
  • Fax: 317-505-1747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAYLA HUFFMAN
Title or Position: FOUNDER, CEO
Credential: FNP
Phone: 317-505-1747