Provider Demographics
NPI:1285709956
Name:HUFFMAN, CAROL A (PNP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 3RD ST SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4611
Mailing Address - Country:US
Mailing Address - Phone:540-857-6993
Mailing Address - Fax:540-857-6999
Practice Address - Street 1:1201 3RD ST SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4611
Practice Address - Country:US
Practice Address - Phone:540-857-6993
Practice Address - Fax:540-857-6999
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017138608363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics