Provider Demographics
NPI:1861640930
Name:HUFF, VICTORIA LAND (CPNP)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LAND
Last Name:HUFF
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3204
Mailing Address - Country:US
Mailing Address - Phone:360-241-5137
Mailing Address - Fax:360-241-5137
Practice Address - Street 1:6911 TERRACE DR
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-3204
Practice Address - Country:US
Practice Address - Phone:360-241-5137
Practice Address - Fax:360-241-5137
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201250031NP363LP0200X
AZAP3101363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ545350Medicaid
OR500646120Medicaid