Provider Demographics
NPI:1417381484
Name:HUFHAM, ANITA C (RN)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:C
Last Name:HUFHAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:C
Other - Last Name:UNDERWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4510 KINGSWAY
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-3206
Mailing Address - Country:US
Mailing Address - Phone:559-707-9988
Mailing Address - Fax:
Practice Address - Street 1:3475 N SARATOGA ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98278-8800
Practice Address - Country:US
Practice Address - Phone:360-257-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60216405163W00000X
TX808885163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse