Provider Demographics
NPI:1336247410
Name:HUFFORD, KRISTI L (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:L
Last Name:HUFFORD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4341 VEGA LOOP
Mailing Address - Street 2:
Mailing Address - City:SHINGLE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95682-5023
Mailing Address - Country:US
Mailing Address - Phone:530-676-4843
Mailing Address - Fax:
Practice Address - Street 1:3919 PARK DR STE 80
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762
Practice Address - Country:US
Practice Address - Phone:800-972-5547
Practice Address - Fax:916-887-7930
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN465389363L00000X
CANP7453363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner