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General NPI Number Information
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NPI Number | 1548938764
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Entity Type | Individual
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Provider Name | KAYLEY HUFFMAN
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Gender | Female
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 5915 GETWELL RD BLDG B
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City | SOUTHAVEN
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State | MS
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Zip | 38672-6455
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Country | US
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Telephone | 662-349-2979
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Fax | 662-349-2978
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Provider Business Mailing Address
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Address Line | 2931 FLORA LEE DR S
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City | NESBIT
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State | MS
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Zip | 38651-7004
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Country | US
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Telephone | 870-740-3207
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 903808
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 903808
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License Number State | MS
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