Provider Demographics
NPI:1861656134
Name:HUFF, MARILYN (RN)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:HUFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GRACEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-1007
Mailing Address - Country:US
Mailing Address - Phone:570-474-2176
Mailing Address - Fax:
Practice Address - Street 1:943 HUALAPAI WAY
Practice Address - Street 2:
Practice Address - City:PEACH SPRINGS
Practice Address - State:AZ
Practice Address - Zip Code:86434-0190
Practice Address - Country:US
Practice Address - Phone:928-769-2900
Practice Address - Fax:928-769-2933
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN255013L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse