Provider Demographics
NPI:1407232796
Name:HUFF, JODIE LYNNE (CGC)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:LYNNE
Last Name:HUFF
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-688-1330
Mailing Address - Fax:270-688-1338
Practice Address - Street 1:1000 BRECKENRIDGE ST STE 201
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-0876
Practice Address - Country:US
Practice Address - Phone:270-688-3445
Practice Address - Fax:270-688-3444
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYGC007170300000X
KY170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS