Provider Demographics
NPI:1003322900
Name:HUHN, LEONNA (NP)
Entity Type:Individual
Prefix:
First Name:LEONNA
Middle Name:
Last Name:HUHN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2082 ERIC PRICE RD
Mailing Address - Street 2:
Mailing Address - City:TYLERTOWN
Mailing Address - State:MS
Mailing Address - Zip Code:39667-6690
Mailing Address - Country:US
Mailing Address - Phone:601-551-7607
Mailing Address - Fax:
Practice Address - Street 1:102 W FREEDOM DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MS
Practice Address - Zip Code:39645-7295
Practice Address - Country:US
Practice Address - Phone:601-657-8091
Practice Address - Fax:601-657-8873
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902145363LF0000X
MSAG06170178363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health