Provider Demographics
NPI:1619206323
Name:HUFFSTUTLER, HANNAH SALTER (PA-C)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:SALTER
Last Name:HUFFSTUTLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:SALTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 LEAF LAKE BLVD
Mailing Address - Street 2:APT. 1212
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-7251
Mailing Address - Country:US
Mailing Address - Phone:251-979-5969
Mailing Address - Fax:
Practice Address - Street 1:4517 SOUTHLAKE PKWY
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3280
Practice Address - Country:US
Practice Address - Phone:205-985-4111
Practice Address - Fax:205-985-4326
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA-684363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL12144078OtherCAQH
AL121968Medicaid
AL102I970754Medicare PIN