Healthcare Provider Details

I. General information

NPI: 1811412737
Provider Name (Legal Business Name): KATHRYN N HULL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2017
Last Update Date: 08/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S 48TH ST
LINCOLN NE
68510-1830
US

IV. Provider business mailing address

300 S 48TH ST
LINCOLN NE
68510-1830
US

V. Phone/Fax

Practice location:
  • Phone: 402-436-1663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1130
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2776
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: