Healthcare Provider Details

I. General information

NPI: 1396953501
Provider Name (Legal Business Name): MRS. MICHELE LEE HUFFIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHELE LEE CARPER

II. Dates (important events)

Enumeration Date: 05/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 E MOLER ST
COLUMBUS OH
43207-1331
US

IV. Provider business mailing address

537 E MOLER ST
COLUMBUS OH
43207-1331
US

V. Phone/Fax

Practice location:
  • Phone: 614-893-1493
  • Fax:
Mailing address:
  • Phone: 614-893-1493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number2625467
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: