Healthcare Provider Details

I. General information

NPI: 1942667555
Provider Name (Legal Business Name): PAMELA HUFFMAN AGNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 10/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SAM PERRY BLVD STE 280
FREDERICKSBURG VA
22401-8400
US

IV. Provider business mailing address

1201 SAM PERRY BLVD STE 280
FREDERICKSBURG VA
22401-8400
US

V. Phone/Fax

Practice location:
  • Phone: 540-361-2922
  • Fax:
Mailing address:
  • Phone: 540-361-2922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number363LA2200X
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: