Healthcare Provider Details

I. General information

NPI: 1114681475
Provider Name (Legal Business Name): PAGE VIRGINIA HUFFMAN MSN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2021
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11551 NUCKOLS RD STE C
GLEN ALLEN VA
23059-5565
US

IV. Provider business mailing address

11551 NUCKOLS RD STE C
GLEN ALLEN VA
23059-5565
US

V. Phone/Fax

Practice location:
  • Phone: 804-888-6800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024182966
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: