Provider Demographics
NPI:1396866505
Name:HUST, JENNIFER LYNNE (CTRS)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNNE
Last Name:HUST
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 PRINCE RD APT 2
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3148
Mailing Address - Country:US
Mailing Address - Phone:402-480-0796
Mailing Address - Fax:
Practice Address - Street 1:5010 PRINCE RD APT 2
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3148
Practice Address - Country:US
Practice Address - Phone:402-480-0796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE41803225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist