Healthcare Provider Details

I. General information

NPI: 1174387385
Provider Name (Legal Business Name): SHARAYAH HUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 S PLATE ST
KOKOMO IN
46902-2307
US

IV. Provider business mailing address

1712 S PLATE ST
KOKOMO IN
46902-2307
US

V. Phone/Fax

Practice location:
  • Phone: 765-453-5175
  • Fax:
Mailing address:
  • Phone: 765-453-5175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number17001628A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: