Healthcare Provider Details

I. General information

NPI: 1700674892
Provider Name (Legal Business Name): KATRINA ROSE HUHNE CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOPEWELL DR
STONY BROOK NY
11790-2323
US

IV. Provider business mailing address

1 HOPEWELL DR
STONY BROOK NY
11790-2323
US

V. Phone/Fax

Practice location:
  • Phone: 631-364-9830
  • Fax: 631-675-0262
Mailing address:
  • Phone: 631-364-9830
  • Fax: 631-675-0262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNA63185
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberNA63185
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA63185
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: