Healthcare Provider Details
I. General information
NPI: 1891317186
Provider Name (Legal Business Name): MAX A. HUFFMAN APRN.CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/11/2020
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
460 W 10TH AVE
COLUMBUS OH
43210-1240
US
IV. Provider business mailing address
700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US
V. Phone/Fax
- Phone: 614-293-5066
- Fax: 614-293-9449
- Phone: 614-293-5066
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | NP55555 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | APRN.CNP.0027672 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: