Provider Demographics
NPI:1992973101
Name:HUFFMAN, KIMBERLY FOWLER (RN, MSN, APRN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:FOWLER
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:RN, MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 N ELLINGTON PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-2227
Mailing Address - Country:US
Mailing Address - Phone:931-270-3655
Mailing Address - Fax:931-270-3656
Practice Address - Street 1:1090 N ELLINGTON PKWY STE 201
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-2227
Practice Address - Country:US
Practice Address - Phone:931-270-3655
Practice Address - Fax:931-270-3656
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013226363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics