Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 14313 | TN |
NPI | 1003048810 |
---|---|
Provider Name | Mrs. Patricia M Huddleston |
First Address | Knoxville, TN 37920-1500 |
Second Address | Knoxville, TN 37920-2244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2009 |
Last Update Date | 31/10/2013 |