Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 0101236412 | VA |
N | 2081P2900X | Pain Medicine | 0101236412 | VA |
NPI | 1114952298 |
---|---|
Provider Name | Joyce L Huerta |
First Address | Lynchburg, VA 24501-2184 |
Second Address | Lynchburg, VA 24501-2184 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 02/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010160979 | (05) | VA |
1114952298 | (05) | VA |
I05983 | (02) | |
P00220203 | MEDICARE RAILROAD PIN (01) | VA |