Provider Demographics
NPI:1811169881
Name:HUNTINGTON, JOHANN ANTONIO II (RN)
Entity type:Individual
Prefix:
First Name:JOHANN
Middle Name:ANTONIO
Last Name:HUNTINGTON
Suffix:II
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2299 N SILVERBELL RD
Mailing Address - Street 2:4212
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1160
Mailing Address - Country:US
Mailing Address - Phone:520-398-7256
Mailing Address - Fax:
Practice Address - Street 1:1601 W SAINT MARYS RD
Practice Address - Street 2:OPERATING ROOM
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2623
Practice Address - Country:US
Practice Address - Phone:520-872-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-30
Last Update Date:2008-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN-091807163W00000X
FLRN-9173060163W00000X
VARN-0001158222163W00000X
WARN-00147609163W00000X
CA499223163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse