Healthcare Provider Details

I. General information

NPI: 1750076147
Provider Name (Legal Business Name): KENDALL HUFF FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 FLOWOOD DR STE 100
FLOWOOD MS
39232-9304
US

IV. Provider business mailing address

411 LAKEBEND PL
BRANDON MS
39042-2265
US

V. Phone/Fax

Practice location:
  • Phone: 601-939-1444
  • Fax:
Mailing address:
  • Phone: 601-953-1788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number905684
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: