Provider Demographics
NPI:1114375508
Name:HUFFMAN, OLIVIA
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 S 56TH ST
Mailing Address - Street 2:STE 314
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-1889
Mailing Address - Country:US
Mailing Address - Phone:531-500-3259
Mailing Address - Fax:531-500-4205
Practice Address - Street 1:5400 S 56TH ST
Practice Address - Street 2:STE 314
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-1889
Practice Address - Country:US
Practice Address - Phone:531-500-3259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE225100000X
KS11-05325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist