Provider Demographics
NPI:1093826463
Name:HUFF, KATINA ENGLAND (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATINA
Middle Name:ENGLAND
Last Name:HUFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATINA
Other - Middle Name:ENGLAND
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 622
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-0622
Mailing Address - Country:US
Mailing Address - Phone:931-808-1378
Mailing Address - Fax:
Practice Address - Street 1:133 CHURCHILL DR
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-1524
Practice Address - Country:US
Practice Address - Phone:931-836-3262
Practice Address - Fax:931-836-3269
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA633363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNTN0102Medicaid
TN4071330Medicaid
TN10075889Medicaid