Provider Demographics
NPI:1679669063
Name:HUFF, DONNA R (PMHNP-BC, PMHCNS-BC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:R
Last Name:HUFF
Suffix:
Gender:F
Credentials:PMHNP-BC, PMHCNS-BC
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:R
Other - Last Name:KEZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:470 SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04967-4928
Mailing Address - Country:US
Mailing Address - Phone:207-487-5154
Mailing Address - Fax:207-487-3158
Practice Address - Street 1:470 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:ME
Practice Address - Zip Code:04967-4928
Practice Address - Country:US
Practice Address - Phone:207-487-5154
Practice Address - Fax:207-487-3158
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNS84143364SP0809X
MECNP81071363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME104000000Medicaid
ME432022399Medicaid
ME432022399Medicaid
MES62769Medicare UPIN
ME104000000Medicaid