Provider Demographics
NPI:1164600755
Name:HUFFMAN, ROBIN DARLENE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:DARLENE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12204 N WOODLAND ACRES DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:IN
Mailing Address - Zip Code:46567-9152
Mailing Address - Country:US
Mailing Address - Phone:574-457-6331
Mailing Address - Fax:516-714-9396
Practice Address - Street 1:12204 N WOODLAND ACRES DR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:IN
Practice Address - Zip Code:46567-9152
Practice Address - Country:US
Practice Address - Phone:574-457-6331
Practice Address - Fax:516-714-9396
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28178099A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1164600755Medicaid
IN1164600755Medicare NSC