Provider Demographics
NPI:1619669207
Name:HUFFMAN, KRISTEN ANN RENEE
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANN RENEE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19
Mailing Address - Street 2:
Mailing Address - City:HANOVERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44423-0019
Mailing Address - Country:US
Mailing Address - Phone:330-754-5556
Mailing Address - Fax:
Practice Address - Street 1:29900 CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:HANOVERTON
Practice Address - State:OH
Practice Address - Zip Code:44423-8622
Practice Address - Country:US
Practice Address - Phone:330-754-5556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay