Provider Demographics
NPI:1508393448
Name:HUFFORD, DANIELLE IVY (CNA, MA, TRACKER, FS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:IVY
Last Name:HUFFORD
Suffix:
Gender:F
Credentials:CNA, MA, TRACKER, FS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1623
Mailing Address - Country:US
Mailing Address - Phone:308-220-0088
Mailing Address - Fax:
Practice Address - Street 1:213 W 26TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1623
Practice Address - Country:US
Practice Address - Phone:308-220-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE92077376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide