Individual
MARLANA HUFFSTATLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
109 HIGHWAY 15 S, PONTOTOC, MS 38863-2628
(662) 509-9934
(662) 509-9935
Mailing address
109 HIGHWAY 15 S, PONTOTOC, MS 38863-2628
(662) 509-9934
(662) 509-9935
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R877004
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05830268
—
MS
Enumeration date
09/24/2014
Last updated
08/08/2016
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