Provider Demographics
NPI:1114206224
Name:HUFFMAN, TERRI LYNN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:LYNN
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S1055 COON BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN DELLS
Mailing Address - State:WI
Mailing Address - Zip Code:53965-8250
Mailing Address - Country:US
Mailing Address - Phone:608-415-3530
Mailing Address - Fax:
Practice Address - Street 1:S1055 COON BLUFF RD
Practice Address - Street 2:
Practice Address - City:WISCONSIN DELLS
Practice Address - State:WI
Practice Address - Zip Code:53965-8250
Practice Address - Country:US
Practice Address - Phone:608-415-3530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI32899-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse