Provider Demographics
NPI:1528799749
Name:HUFF, KIMBERLY S (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:S
Last Name:HUFF
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2882 STILLCREST LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-7041
Mailing Address - Country:US
Mailing Address - Phone:317-691-2191
Mailing Address - Fax:
Practice Address - Street 1:152 WITTENBRAKER AVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-5000
Practice Address - Country:US
Practice Address - Phone:765-599-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71012638A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health