Provider Demographics
NPI:1396997037
Name:HUFFMAN, ANDREA K (PA)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:K
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:J
Other - Last Name:KEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:5665 PEACHTREE DUNWOODY RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1764
Mailing Address - Country:US
Mailing Address - Phone:404-778-1900
Mailing Address - Fax:678-843-6849
Practice Address - Street 1:5665 PEACHTREE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1764
Practice Address - Country:US
Practice Address - Phone:404-778-1900
Practice Address - Fax:678-843-6849
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005468363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant