Provider Demographics
NPI:1720718539
Name:HUXFORD, ANNE MARGARET
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARGARET
Last Name:HUXFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARGARET
Other - Last Name:FLICEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:295 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LE CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:56057-1514
Mailing Address - Country:US
Mailing Address - Phone:952-836-6690
Mailing Address - Fax:
Practice Address - Street 1:1025 MARSH ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4752
Practice Address - Country:US
Practice Address - Phone:952-836-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11620363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care