Provider Demographics
NPI:1295783983
Name:HUFF, MARY J (PSYCHIATRIC NP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:J
Last Name:HUFF
Suffix:
Gender:
Credentials:PSYCHIATRIC NP
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 3658
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86003-3658
Mailing Address - Country:US
Mailing Address - Phone:928-308-3715
Mailing Address - Fax:
Practice Address - Street 1:143 N MCCORMICK ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-2723
Practice Address - Country:US
Practice Address - Phone:928-308-3715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2067363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health