Healthcare Provider Details

I. General information

NPI: 1841419918
Provider Name (Legal Business Name): JESSIEANN S HUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 S 100 E
PRICE UT
84501-3002
US

IV. Provider business mailing address

PO BOX 800
PRICE UT
84501-0800
US

V. Phone/Fax

Practice location:
  • Phone: 435-637-3671
  • Fax: 435-637-1933
Mailing address:
  • Phone: 435-637-3671
  • Fax: 435-637-1933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number195069-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: