Healthcare Provider Details

I. General information

NPI: 1467481010
Provider Name (Legal Business Name): AARON LEROY HUFFSTUTTER FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 03/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 E 10TH ST
TRENTON MO
64683-9579
US

IV. Provider business mailing address

189 IOWA BLVD
TRENTON MO
64683-8343
US

V. Phone/Fax

Practice location:
  • Phone: 660-359-3939
  • Fax: 660-359-4372
Mailing address:
  • Phone: 660-359-3939
  • Fax: 660-359-4372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN15838
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: