Healthcare Provider Details

I. General information

NPI: 1780182477
Provider Name (Legal Business Name): WHITNEY E HUFFINGHAM CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2018
Last Update Date: 03/26/2020
Certification Date: 03/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 ASHLEY CIR
BOWLING GREEN KY
42104-3362
US

IV. Provider business mailing address

110 29TH AVE N STE 202
NASHVILLE TN
37203-1448
US

V. Phone/Fax

Practice location:
  • Phone: 270-793-1000
  • Fax:
Mailing address:
  • Phone: 615-327-4304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number223924
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN223924
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3014116
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: