Provider Demographics
NPI:1750888731
Name:HUTCHINGS, SHELBY ANN (MOT)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:ANN
Last Name:HUTCHINGS
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14211 MONROE CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-4825
Mailing Address - Country:US
Mailing Address - Phone:402-850-6879
Mailing Address - Fax:
Practice Address - Street 1:11041 N 137TH ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:NE
Practice Address - Zip Code:68462-1022
Practice Address - Country:US
Practice Address - Phone:402-786-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2167225X00000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist