Provider Demographics
NPI:1285224410
Name:HUFF, CLARA (NP)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:HUFF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 SHALLOW WAY
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-4520
Mailing Address - Country:US
Mailing Address - Phone:678-577-4169
Mailing Address - Fax:
Practice Address - Street 1:112 SHALLOW WAY
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-4520
Practice Address - Country:US
Practice Address - Phone:678-577-4169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN201451363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN201451OtherNURSING LICENSE