Provider Demographics
NPI:1467481010
Name:HUFFSTUTTER, AARON LEROY (FNP)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:LEROY
Last Name:HUFFSTUTTER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 IOWA BLVD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683-8343
Mailing Address - Country:US
Mailing Address - Phone:660-359-3939
Mailing Address - Fax:660-359-4372
Practice Address - Street 1:3300 E 10TH ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MO
Practice Address - Zip Code:64683-9579
Practice Address - Country:US
Practice Address - Phone:660-359-3939
Practice Address - Fax:660-359-4372
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN15838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOQ49526Medicare UPIN