Provider Demographics
NPI:1659787638
Name:HUFFMAN, ELLEN SARAH (RN)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:SARAH
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:SARAH
Other - Last Name:RAMSETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:2980 RICE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE CANADA
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2230
Mailing Address - Country:US
Mailing Address - Phone:651-488-4655
Mailing Address - Fax:651-488-4656
Practice Address - Street 1:611 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-2504
Practice Address - Country:US
Practice Address - Phone:507-434-4900
Practice Address - Fax:507-434-4919
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR221235-9163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health