Healthcare Provider Details

I. General information

NPI: 1205870490
Provider Name (Legal Business Name): RODNEY HUFF FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CAMPUS BLVD STE 100
WINCHESTER VA
22601-6906
US

IV. Provider business mailing address

400 CAMPUS BLVD STE 100
WINCHESTER VA
22601-6906
US

V. Phone/Fax

Practice location:
  • Phone: 540-662-1108
  • Fax:
Mailing address:
  • Phone: 540-662-1108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0017001530
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: