Provider Demographics
NPI:1023770203
Name:HUFFAKER, ALEXIS LAYNE (CMAA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:LAYNE
Last Name:HUFFAKER
Suffix:
Gender:F
Credentials:CMAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 MOHAWK BLVD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74110-1519
Mailing Address - Country:US
Mailing Address - Phone:918-280-9800
Mailing Address - Fax:918-430-1995
Practice Address - Street 1:2442 MOHAWK BLVD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74110-1519
Practice Address - Country:US
Practice Address - Phone:918-280-9800
Practice Address - Fax:918-430-1995
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist