Provider Demographics
NPI:1518438969
Name:HUFFMAN-HALL, JIMMENA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JIMMENA
Middle Name:
Last Name:HUFFMAN-HALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:JIMMENA
Other - Middle Name:
Other - Last Name:HUFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2004 COTTON BARN CT
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:NC
Mailing Address - Zip Code:27591-9820
Mailing Address - Country:US
Mailing Address - Phone:919-741-3021
Mailing Address - Fax:
Practice Address - Street 1:605 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2026
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2019-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011280363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily