Healthcare Provider Details

I. General information

NPI: 1194336677
Provider Name (Legal Business Name): KATHERINE JANE HUFFHINES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 PENNSYLVANIA AVE STE 450
FORT WORTH TX
76104-2191
US

IV. Provider business mailing address

1325 PENNSYLVANIA AVE STE 450
FORT WORTH TX
76104-2191
US

V. Phone/Fax

Practice location:
  • Phone: 817-250-7240
  • Fax: 888-977-1985
Mailing address:
  • Phone: 817-250-7240
  • Fax: 888-977-1985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1000150
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: