Healthcare Provider Details

I. General information

NPI: 1164482261
Provider Name (Legal Business Name): PAULA R. HUFFMAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA GUTKOWSKI CRNA

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 SANDY BRAE DR
CANONSBURG PA
15317-4958
US

IV. Provider business mailing address

158 SANDY BRAE DR
CANONSBURG PA
15317-4958
US

V. Phone/Fax

Practice location:
  • Phone: 724-344-4312
  • Fax:
Mailing address:
  • Phone: 724-344-4312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN189026L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: