Healthcare Provider Details

I. General information

NPI: 1831920677
Provider Name (Legal Business Name): ANITA HULM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 08/13/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 ILLIONIS ST
SIDNEY NE
69162
US

IV. Provider business mailing address

12710 ROAD 58
DALTON NE
69131-7240
US

V. Phone/Fax

Practice location:
  • Phone: 308-249-7853
  • Fax:
Mailing address:
  • Phone: 308-249-7853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14012
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: