Provider Demographics
NPI:1588957930
Name:HUFF, RENEE L (LPN)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:L
Last Name:HUFF
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BROOKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963-9723
Mailing Address - Country:US
Mailing Address - Phone:570-617-0541
Mailing Address - Fax:
Practice Address - Street 1:20 BROOKSIDE CT
Practice Address - Street 2:
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963-9723
Practice Address - Country:US
Practice Address - Phone:570-617-0541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN281246164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse