Provider Demographics
NPI:1114225992
Name:HUFF, KATHRYN (NURSING)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:HUFF
Suffix:
Gender:F
Credentials:NURSING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8206 ROCKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-3113
Mailing Address - Country:US
Mailing Address - Phone:317-987-1685
Mailing Address - Fax:317-353-6228
Practice Address - Street 1:1003 S FLEMING ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-2412
Practice Address - Country:US
Practice Address - Phone:317-987-1685
Practice Address - Fax:317-353-6228
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN200425060 A251C00000X
IN251E00000X, 251J00000X, 251K00000X, 251X00000X, 252Y00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No251X00000XAgenciesSupports Brokerage
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200425060 AMedicaid