Provider Demographics
NPI:1467224576
Name:HULS, MICHELLE MICHELLE (MS, RDN, LMNT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MICHELLE
Last Name:HULS
Suffix:
Gender:F
Credentials:MS, RDN, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-1489
Mailing Address - Country:US
Mailing Address - Phone:308-233-4727
Mailing Address - Fax:
Practice Address - Street 1:4715 2ND AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2417
Practice Address - Country:US
Practice Address - Phone:308-455-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE467133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered