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Individual
MS. AMANDA RAE HUITE
Active
Individual
MS. AMANDA RAE HUITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.003634
IL
363A00000X
Physician Assistant
Primary
PA2142
NV
363A00000X
Physician Assistant
PA56838
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208084
MEDICARE GROUP NUMBER
IL
01
—
214881
GROUP PTAN
IL
Enumeration date
10/22/2009
Last updated
12/17/2020
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