Healthcare Provider Details

I. General information

NPI: 1326602897
Provider Name (Legal Business Name): MADISON HUFF NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 04/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 2ND AVE SE
MINOT ND
58701-3906
US

IV. Provider business mailing address

1940 S BROADWAY # 312
MINOT ND
58701-6508
US

V. Phone/Fax

Practice location:
  • Phone: 701-587-3538
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR36222
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: