Provider Demographics
NPI:1053959924
Name:HUFF, SHAWNTEL (RN)
Entity type:Individual
Prefix:MRS
First Name:SHAWNTEL
Middle Name:
Last Name:HUFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4074 E DEVON DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1407
Mailing Address - Country:US
Mailing Address - Phone:480-225-7483
Mailing Address - Fax:
Practice Address - Street 1:4074 E DEVON DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-1407
Practice Address - Country:US
Practice Address - Phone:480-225-7483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN106178163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse