Individual
ELLEN A HUDDLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 20TH AVE N STE 505, NASHVILLE, TN 37203-2131
(615) 340-4655
(615) 340-4596
Mailing address
300 20TH AVE N STE 505, NASHVILLE, TN 37203-2131
(615) 340-4655
(615) 340-4596
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1752
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970022269
MEDICARE RR
FL
Enumeration date
06/21/2006
Last updated
08/31/2021
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