Basic Information
| Provider Information | |||||||||
| NPI: | 1700819406 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUFANA | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 98978 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891938978 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022163346 | ||||||||
| FaxNumber: | 7026716883 | ||||||||
| Practice Location | |||||||||
| Address1: | 3930 W CRAIG RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | NORTH LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890322729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024738380 | ||||||||
| FaxNumber: | 7024738383 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 03/07/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 43708 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 28822 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 16133 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 16133 | 01 | NV | STATE LICENSE | OTHER | 1700819406 | 05 | NV | MEDICAID | 3001321 | 05 | TN | MEDICAID |