Healthcare Provider Details

I. General information

NPI: 1467485433
Provider Name (Legal Business Name): JENIFFER LYNN HUHN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 01/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 EASTERN BYP SUITE G2
RICHMOND KY
40475-2422
US

IV. Provider business mailing address

1300 HOSPITAL DR STE 101
FREDERICKSBURG VA
22401-8451
US

V. Phone/Fax

Practice location:
  • Phone: 859-626-0074
  • Fax: 859-626-3265
Mailing address:
  • Phone: 540-741-0655
  • Fax: 540-741-0657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number0102204423
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: