Healthcare Provider Details

I. General information

NPI: 1164735700
Provider Name (Legal Business Name): SABRINA R HUFFSTETLER APN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2010
Last Update Date: 07/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 BROADERICK BLVD
MARYVILLE TN
37801-9002
US

IV. Provider business mailing address

1265 BROADERICK BLVD
MARYVILLE TN
37801-9002
US

V. Phone/Fax

Practice location:
  • Phone: 865-659-9894
  • Fax:
Mailing address:
  • Phone: 865-659-9894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License NumberRN0000101157
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15586
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: