Provider Demographics
NPI:1083889000
Name:HUFFMAN, BRIANNE NICOLE (AID)
Entity Type:Individual
Prefix:MISS
First Name:BRIANNE
Middle Name:NICOLE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 OAKCREST CT
Mailing Address - Street 2:
Mailing Address - City:RUSSELLS POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43348-1937
Mailing Address - Country:US
Mailing Address - Phone:193-784-3609
Mailing Address - Fax:
Practice Address - Street 1:212 OAKCREST CT
Practice Address - Street 2:
Practice Address - City:RUSSELLS POINT
Practice Address - State:OH
Practice Address - Zip Code:43348-1937
Practice Address - Country:US
Practice Address - Phone:193-784-3609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2807163374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10305845000OtherCARESOURCE