Provider Demographics
NPI:1427469238
Name:HUKILL, DRENDA MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:DRENDA
Middle Name:MARIE
Last Name:HUKILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DRENDA
Other - Middle Name:MARIE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1335 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1242
Mailing Address - Country:US
Mailing Address - Phone:989-463-2181
Mailing Address - Fax:989-463-1713
Practice Address - Street 1:1335 PINE AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1242
Practice Address - Country:US
Practice Address - Phone:989-463-2181
Practice Address - Fax:989-463-1713
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704235555363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner