Healthcare Provider Details

I. General information

NPI: 1932602976
Provider Name (Legal Business Name): JENNIFER HUFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 10/29/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 DUDLEY AVENUE
PARKERSBURG WV
26101-3462
US

IV. Provider business mailing address

PO BOX 609
ELIZABETH WV
26143-0609
US

V. Phone/Fax

Practice location:
  • Phone: 304-861-4150
  • Fax: 304-422-2170
Mailing address:
  • Phone: 304-275-3301
  • Fax: 304-275-4798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN69337-FNP-BC
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: