Provider Demographics
NPI:1588217871
Name:HUFFMAN, JAMIE M (CNP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:M
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:M
Other - Last Name:HUFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-8315
Mailing Address - Fax:614-293-6935
Practice Address - Street 1:395 W 12TH AVE RM 460
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1267
Practice Address - Country:US
Practice Address - Phone:614-293-8315
Practice Address - Fax:614-293-6935
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRNCNP025369363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0363705Medicaid