Healthcare Provider Details

I. General information

NPI: 1811099732
Provider Name (Legal Business Name): LINDA MCCLOUD HUFFMAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 TOD LN
YOUNGSTOWN OH
44504-1404
US

IV. Provider business mailing address

402 TOD LN
YOUNGSTOWN OH
44504-1404
US

V. Phone/Fax

Practice location:
  • Phone: 330-743-9596
  • Fax:
Mailing address:
  • Phone: 330-743-9596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: