Healthcare Provider Details

I. General information

NPI: 1295415875
Provider Name (Legal Business Name): CAMERON DANIELLE HUCKE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 O ST STE 300
LINCOLN NE
68510-2647
US

IV. Provider business mailing address

1234 N TURNER AVE
HASTINGS NE
68901-7669
US

V. Phone/Fax

Practice location:
  • Phone: 402-984-9468
  • Fax:
Mailing address:
  • Phone: 402-984-9468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number1733
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1733
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: