Healthcare Provider Details

I. General information

NPI: 1346339553
Provider Name (Legal Business Name): ROBERT A HUFFMAN FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 06/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 N ELM ST
LUMBERTON NC
28358-3011
US

IV. Provider business mailing address

208 HEMLOCK DR
WHITEVILLE NC
28472-8982
US

V. Phone/Fax

Practice location:
  • Phone: 910-671-6177
  • Fax: 910-671-6770
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number200993
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: