Provider Demographics
NPI:1669087599
Name:NIDA-HUFF, HEIDI MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARIE
Last Name:NIDA-HUFF
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W LONE CACTUS DR STE B
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-2648
Mailing Address - Country:US
Mailing Address - Phone:405-880-5681
Mailing Address - Fax:
Practice Address - Street 1:1610 E CAMELBACK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3902
Practice Address - Country:US
Practice Address - Phone:602-277-1727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ247283363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily