Healthcare Provider Details

I. General information

NPI: 1699293100
Provider Name (Legal Business Name): MELANIE MINIX HUFFINE RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2017
Last Update Date: 09/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 HAGER BR
EAST POINT KY
41216-8766
US

IV. Provider business mailing address

709 RIVERBRANCH CT
NASHVILLE TN
37221-6599
US

V. Phone/Fax

Practice location:
  • Phone: 606-886-0808
  • Fax: 259-813-0824
Mailing address:
  • Phone: 615-336-4148
  • Fax: 859-813-0824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number4946
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: