Provider Demographics
NPI:1205586112
Name:HUFF, KIRSTEN MARAE (WHNP)
Entity type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:MARAE
Last Name:HUFF
Suffix:
Gender:
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412065
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2065
Mailing Address - Country:US
Mailing Address - Phone:314-432-8181
Mailing Address - Fax:314-432-0090
Practice Address - Street 1:3023 N BALLAS RD
Practice Address - Street 2:STE 440D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2330
Practice Address - Country:US
Practice Address - Phone:314-432-8181
Practice Address - Fax:314-432-0090
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021038739363LW0102X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420125950Medicaid