Healthcare Provider Details

I. General information

NPI: 1427143940
Provider Name (Legal Business Name): CYNTHIA O HUFF EDD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 PRINCE ST
SEVIERVILLE TN
37862
US

IV. Provider business mailing address

701 CENTEROAK DR.
KNOXVILLE TN
37920
US

V. Phone/Fax

Practice location:
  • Phone: 865-774-7781
  • Fax: 865-908-2455
Mailing address:
  • Phone: 865-577-4385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN 0000005095
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: