Provider Demographics
NPI:1669070512
Name:HUFFMAN, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:
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 249
Mailing Address - Street 2:
Mailing Address - City:MINNEWAUKAN
Mailing Address - State:ND
Mailing Address - Zip Code:58351-0249
Mailing Address - Country:US
Mailing Address - Phone:701-473-5552
Mailing Address - Fax:
Practice Address - Street 1:4191 63 AVE NE
Practice Address - Street 2:
Practice Address - City:MINNEAUAKAN
Practice Address - State:ND
Practice Address - Zip Code:58351
Practice Address - Country:US
Practice Address - Phone:701-473-5552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant