Humana change of address 2026

1. Click ‘Get Form’ to open the humana change of address form in the editor.
2. Begin by entering the Provider Name. Fill in the Last Name, First Name, and Middle Initial as required.
3. Provide the Provider Social Security Number and NPI for SSN. Choose whether you are adding a location or changing existing information by checking the appropriate box.
4. Enter the Effective Date for the changes and specify if this is a new Primary Location. Fill in the complete address, ensuring no PO Boxes are used.
5. Complete additional fields such as County, Email, Phone Number, and Fax Number. If applicable, submit a W-9 for a new Tax ID.
6. Indicate if your location is Handicapped Accessible and Public Transportation Accessible by checking 'Yes' or 'No'.
7. If there are locations to delete or if your mailing address has changed, provide that information accordingly.
8. Finally, ensure all sections are filled out accurately before submitting your completed form via fax or mail as indicated.

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