Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD61652 | TN |
NPI | 1013394691 |
---|---|
Provider Name | Dr. Jessica Grace Huffstutter |
First Address | Hixson, TN 37343-7908 |
Second Address | Hixson, TN 37343-7908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2015 |
Last Update Date | 29/03/2021 |