Healthcare Provider Details

I. General information

NPI: 1063860526
Provider Name (Legal Business Name): DAVID HUFFMAN PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 N HIGH ST
COLUMBUS OH
43201
US

IV. Provider business mailing address

735 PRAIRIE RUN DR
SUNBURY OH
43074-8541
US

V. Phone/Fax

Practice location:
  • Phone: 614-299-6600
  • Fax:
Mailing address:
  • Phone: 419-651-3538
  • Fax: 614-317-4689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN349279
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.022856
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: