Provider Demographics
NPI:1114100237
Name:HUFFSTETLER, NICOLA RASCHELLA (CRNA)
Entity Type:Individual
Prefix:
First Name:NICOLA
Middle Name:RASCHELLA
Last Name:HUFFSTETLER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NICOLA
Other - Middle Name:MARIE
Other - Last Name:RASCHELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:415 N CENTER ST
Mailing Address - Street 2:STE 201
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5036
Mailing Address - Country:US
Mailing Address - Phone:828-327-8105
Mailing Address - Fax:
Practice Address - Street 1:415 N CENTER ST
Practice Address - Street 2:STE 201
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5036
Practice Address - Country:US
Practice Address - Phone:828-327-8105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172937367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8053059Medicaid
NC8053059Medicaid