Provider Demographics
NPI:1841419918
Name:HUFF, JESSIEANN S
Entity Type:Individual
Prefix:
First Name:JESSIEANN
Middle Name:S
Last Name:HUFF
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 800
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-0800
Mailing Address - Country:US
Mailing Address - Phone:435-637-3671
Mailing Address - Fax:435-637-1933
Practice Address - Street 1:28 S 100 E
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-3002
Practice Address - Country:US
Practice Address - Phone:435-637-3671
Practice Address - Fax:435-637-1933
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT195069-3102163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD2813Medicaid