Provider Demographics
NPI:1306458187
Name:HUFF, CARLA JEAN
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:JEAN
Last Name:HUFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 OAK LN
Mailing Address - Street 2:
Mailing Address - City:APPLE GROVE
Mailing Address - State:WV
Mailing Address - Zip Code:25502-7751
Mailing Address - Country:US
Mailing Address - Phone:304-576-4377
Mailing Address - Fax:
Practice Address - Street 1:609 OAK LN
Practice Address - Street 2:
Practice Address - City:APPLE GROVE
Practice Address - State:WV
Practice Address - Zip Code:25502-7751
Practice Address - Country:US
Practice Address - Phone:304-576-4377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant