Healthcare Provider Details

I. General information

NPI: 1780013045
Provider Name (Legal Business Name): NANCY N HUFFMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 CASSELL DR
KINGSPORT TN
37660-3775
US

IV. Provider business mailing address

113 CASSELL DR
KINGSPORT TN
37660-3775
US

V. Phone/Fax

Practice location:
  • Phone: 423-246-7240
  • Fax:
Mailing address:
  • Phone: 423-246-7240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS21042
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number31939
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number09427
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: