Healthcare Provider Details

I. General information

NPI: 1760978464
Provider Name (Legal Business Name): KATHRYN R HUHMANN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 N 93RD ST
OMAHA NE
68134-4717
US

IV. Provider business mailing address

818 5TH AVE STE 200
DES MOINES IA
50309-1303
US

V. Phone/Fax

Practice location:
  • Phone: 877-811-7526
  • Fax: 402-496-0489
Mailing address:
  • Phone: 515-280-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF159010
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number112574
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: