Healthcare Provider Details

I. General information

NPI: 1811274947
Provider Name (Legal Business Name): NATASHA LYNN HUFFORD S.T.N.A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 S SMITHVILLE RD APARTMENT 10
DAYTON OH
45410-3243
US

IV. Provider business mailing address

1509 S SMITHVILLE RD APARTMENT 10
DAYTON OH
45410-3243
US

V. Phone/Fax

Practice location:
  • Phone: 937-248-8047
  • Fax:
Mailing address:
  • Phone: 937-248-8047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number400250960603
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: