Healthcare Provider Details

I. General information

NPI: 1720754146
Provider Name (Legal Business Name): SAMANTHA LEIGH HUFFMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 RIBAUT RD
BEAUFORT SC
29902-5441
US

IV. Provider business mailing address

955 RIBAUT RD
BEAUFORT SC
29902-5441
US

V. Phone/Fax

Practice location:
  • Phone: 843-858-1098
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN372349
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN311450
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: