Healthcare Provider Details

I. General information

NPI: 1700836673
Provider Name (Legal Business Name): SPRING A HUFFMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SPRING A BOEDDEKER

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 UNIVERSITY DR S
FARGO ND
58103-4940
US

IV. Provider business mailing address

400 E 3RD ST
DULUTH MN
55805-1951
US

V. Phone/Fax

Practice location:
  • Phone: 701-364-8900
  • Fax:
Mailing address:
  • Phone: 701-364-4999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR 194077-4
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP 3591
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR33815
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: