Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | D42046 | MD |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 0101259307 | VA |
NPI | 1457461014 |
---|---|
Provider Name | Grace Brooke Huffman |
First Address | Winchester, VA 22601-2808 |
Second Address | Winchester, VA 22601-2808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 28/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
788351000 | (05) | MD |
E74932 | (02) |