Healthcare Provider Details

I. General information

NPI: 1639306848
Provider Name (Legal Business Name): JESSICA ANN HUFF FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 09/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10095 BRICK CHURCH RD
CAMBRIDGE OH
43725-8550
US

IV. Provider business mailing address

1251 CLARK ST
CAMBRIDGE OH
43725-9612
US

V. Phone/Fax

Practice location:
  • Phone: 740-439-8191
  • Fax:
Mailing address:
  • Phone: 740-439-0733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number321080
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: