Provider Demographics
NPI:1649069048
Name:HUG, FREDERICK MARSHALL JR (PMHNP)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:MARSHALL
Last Name:HUG
Suffix:JR
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 JONES ST APT 230
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1271
Mailing Address - Country:US
Mailing Address - Phone:402-807-9529
Mailing Address - Fax:
Practice Address - Street 1:2821 S 108TH ST STE 3
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4800
Practice Address - Country:US
Practice Address - Phone:402-452-9856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE115994363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health