Provider Demographics
NPI:1629323860
Name:HUFFMAN, DEBORAH (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:ARNP
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 41113
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32203-1113
Mailing Address - Country:US
Mailing Address - Phone:904-398-5404
Mailing Address - Fax:904-391-5545
Practice Address - Street 1:841 PRUDENTIAL DR
Practice Address - Street 2:10TH FLOOR
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8329
Practice Address - Country:US
Practice Address - Phone:904-398-5404
Practice Address - Fax:904-391-5595
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2897672363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01605445OtherRAILROAD MEDICARE
FLP01605445OtherRAILROAD MEDICARE