Provider Demographics
NPI:1225415656
Name:HUFF, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:HUFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 VANBUREN ST.
Mailing Address - Street 2:APT #A409
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201
Mailing Address - Country:US
Mailing Address - Phone:517-917-1312
Mailing Address - Fax:
Practice Address - Street 1:308 VANBUREN ST.
Practice Address - Street 2:A409
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-8915
Practice Address - Country:US
Practice Address - Phone:517-917-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703112236164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse