Provider Demographics
NPI:1750363073
Name:HILL, SUNDEE LYNN (DPT)
Entity type:Individual
Prefix:
First Name:SUNDEE
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SUNDEE
Other - Middle Name:LYNN
Other - Last Name:HEGGEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4110 S 144TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1013
Mailing Address - Country:US
Mailing Address - Phone:402-861-6683
Mailing Address - Fax:402-861-6689
Practice Address - Street 1:4110 S 144TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1013
Practice Address - Country:US
Practice Address - Phone:402-861-6683
Practice Address - Fax:402-861-6689
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09154OtherBLUE CROSS BLUE SHIELD
IA0586388Medicaid
NEP45618Medicare UPIN
NE274876Medicare ID - Type UnspecifiedMEDICARE NUMBER