Provider Demographics
NPI:1073574737
Name:HUFFNER, JEANNE (FNP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:HUFFNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:
Other - Last Name:PAUL-ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:109 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-7713
Mailing Address - Country:US
Mailing Address - Phone:740-695-2090
Mailing Address - Fax:740-695-4116
Practice Address - Street 1:109 PLAZA DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-7713
Practice Address - Country:US
Practice Address - Phone:740-695-2090
Practice Address - Fax:740-695-4116
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN39382-FNP-BC363LF0000X
OHAPRN.CNP.12370363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9600214000Medicaid
OH2232908Medicaid
1073574737Medicare PIN