Provider Demographics
NPI:1164482261
Name:HUFFMAN, PAULA R (CRNA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:R
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:GUTKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:158 SANDY BRAE DR
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-4958
Mailing Address - Country:US
Mailing Address - Phone:724-344-4312
Mailing Address - Fax:
Practice Address - Street 1:158 SANDY BRAE DR
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-4958
Practice Address - Country:US
Practice Address - Phone:724-344-4312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN189026L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
888942Medicare ID - Type Unspecified