Provider Demographics
NPI:1922453984
Name:HULETT, CLAIRE E (PTA)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:E
Last Name:HULETT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11704 W CENTER RD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4375
Mailing Address - Country:US
Mailing Address - Phone:402-691-0500
Mailing Address - Fax:402-691-1586
Practice Address - Street 1:11704 W CENTER RD
Practice Address - Street 2:SUITE #200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4375
Practice Address - Country:US
Practice Address - Phone:402-691-0500
Practice Address - Fax:402-691-1586
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1433225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant