Provider Demographics
NPI:1154565570
Name:HUFF, JENNA R (MD)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:R
Last Name:HUFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:ROSE
Other - Last Name:BERKRAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:210 SUNNYVIEW LANE
Mailing Address - Street 2:201
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-752-5252
Mailing Address - Fax:406-752-5261
Practice Address - Street 1:210 SUNNYVIEW LANE
Practice Address - Street 2:201
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-752-5252
Practice Address - Fax:406-752-5261
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT58349207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000538616Medicaid