Healthcare Provider Details

I. General information

NPI: 1114477726
Provider Name (Legal Business Name): TERI HUFFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 KILSON DR STE 106
MOORESVILLE NC
28117-8182
US

IV. Provider business mailing address

107 KILSON DR STE 106
MOORESVILLE NC
28117-8182
US

V. Phone/Fax

Practice location:
  • Phone: 704-230-1305
  • Fax: 704-230-4367
Mailing address:
  • Phone: 704-230-1305
  • Fax: 704-230-4367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: