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Individual

KELLY ANN WATSON HUFFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
9 SAINT PAUL ST STE 3, BOONSBORO, MD 21713-1334
(301) 432-6897
Mailing address
9 SAINT PAUL ST STE 3, BOONSBORO, MD 21713-1334
(301) 432-6897

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R100502
MD
363LP2300X
Primary Care Nurse Practitioner
Primary
R100502
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1982686945
MEDICAID NPI
MD
05
506600000
MD
01
P00007022
MEDICARE RAILROAD
MD
Enumeration date
11/16/2005
Last updated
08/25/2023
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