Healthcare Provider Details

I. General information

NPI: 1497444723
Provider Name (Legal Business Name): BRETNEY HUFF NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5240 MACCORKLE AVE SE
CHARLESTON WV
25304-2122
US

IV. Provider business mailing address

5240 MACCORKLE AVE SE
CHARLESTON WV
25304-2122
US

V. Phone/Fax

Practice location:
  • Phone: 681-264-4986
  • Fax:
Mailing address:
  • Phone: 681-264-4986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number116099
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: