Healthcare Provider Details

I. General information

NPI: 1750286019
Provider Name (Legal Business Name): TRACIE LYNN HUFFMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 STATE ROUTE 792
STOCKPORT OH
43787-9344
US

IV. Provider business mailing address

1645 E CHILDS LN
MCCONNELSVILLE OH
43756-9544
US

V. Phone/Fax

Practice location:
  • Phone: 740-559-2377
  • Fax: 888-726-8371
Mailing address:
  • Phone: 740-221-0750
  • Fax: 888-726-8371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.345924
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: