Healthcare Provider Details

I. General information

NPI: 1083182513
Provider Name (Legal Business Name): BROOKE HUFFMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2018
Last Update Date: 11/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 FARMHOUSE LN
BOZEMAN MT
59715-9402
US

IV. Provider business mailing address

PO BOX 194
BOZEMAN MT
59771-0194
US

V. Phone/Fax

Practice location:
  • Phone: 406-556-6500
  • Fax:
Mailing address:
  • Phone: 406-580-7537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number132667
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: