Healthcare Provider Details

I. General information

NPI: 1679669063
Provider Name (Legal Business Name): DONNA R HUFF PMHNP-BC, PMHCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. DONNA R. KEZER

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 SOMERSET AVE
PITTSFIELD ME
04967-4928
US

IV. Provider business mailing address

470 SOMERSET AVE
PITTSFIELD ME
04967-4928
US

V. Phone/Fax

Practice location:
  • Phone: 207-487-5154
  • Fax: 207-487-3158
Mailing address:
  • Phone: 207-487-5154
  • Fax: 207-487-3158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberCNS84143
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP81071
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: