Provider Demographics
NPI:1639306848
Name:HUFF, JESSICA ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:HUFF
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-9612
Mailing Address - Country:US
Mailing Address - Phone:740-439-0733
Mailing Address - Fax:
Practice Address - Street 1:10095 BRICK CHURCH RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-8550
Practice Address - Country:US
Practice Address - Phone:740-439-8191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH321080363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3006571Medicaid
OHH190901Medicare PIN