Healthcare Provider Details

I. General information

NPI: 1588577266
Provider Name (Legal Business Name): LAQUANTA A HUDDLESTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 OLD LASCASSAS RD APT F
MURFREESBORO TN
37130-1770
US

IV. Provider business mailing address

1245 OLD LASCASSAS RD APT F
MURFREESBORO TN
37130-1770
US

V. Phone/Fax

Practice location:
  • Phone: 931-217-7544
  • Fax:
Mailing address:
  • Phone: 931-217-7544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: