Provider Demographics
NPI:1265108393
Name:HUFFMAN, CALEB (FNP)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10013 PLYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:HANOVERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44423-9709
Mailing Address - Country:US
Mailing Address - Phone:330-420-8963
Mailing Address - Fax:
Practice Address - Street 1:8840 BLAKENEY PROFESSIONAL DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6806
Practice Address - Country:US
Practice Address - Phone:704-672-0449
Practice Address - Fax:866-469-2745
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017737363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily