Provider Demographics
NPI:1508369687
Name:HUFF, BROOKE RENAE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:RENAE
Last Name:HUFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1928 ALCOA HWY STE B209
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1504
Mailing Address - Country:US
Mailing Address - Phone:865-524-2547
Mailing Address - Fax:865-205-5601
Practice Address - Street 1:1928 ALCOA HWY STE B209
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1504
Practice Address - Country:US
Practice Address - Phone:865-524-2547
Practice Address - Fax:865-205-5601
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3567363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3567OtherSTATE OF TN