Healthcare Provider Details

I. General information

NPI: 1255690236
Provider Name (Legal Business Name): HEATHER W HUFFMAN A.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2012
Last Update Date: 05/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DRIVE
MORGANTOWN WV
26506-8059
US

IV. Provider business mailing address

PO BOX 8216
MORGANTOWN WV
26506-8216
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-4000
  • Fax:
Mailing address:
  • Phone: 304-598-4083
  • Fax: 304-598-4304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number70163
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: