Provider Demographics
NPI:1003921263
Name:HUFF, DEAH REBECCA (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:DEAH
Middle Name:REBECCA
Last Name:HUFF
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14900 SAINT STEPHENS AVE
Mailing Address - Street 2:
Mailing Address - City:CHATOM
Mailing Address - State:AL
Mailing Address - Zip Code:36518-6715
Mailing Address - Country:US
Mailing Address - Phone:251-847-2245
Mailing Address - Fax:
Practice Address - Street 1:14900 SAINT STEPHENS AVE
Practice Address - Street 2:
Practice Address - City:CHATOM
Practice Address - State:AL
Practice Address - Zip Code:36518-6715
Practice Address - Country:US
Practice Address - Phone:251-847-2245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-133796163W00000X, 363L00000X
MSR859705363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06303269Medicaid
500001493Medicare ID - Type Unspecified