Provider Demographics
NPI:1871737627
Name:HUPP, JEANETTE R (HIS)
Entity type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:R
Last Name:HUPP
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 W MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4432
Mailing Address - Country:US
Mailing Address - Phone:402-860-5478
Mailing Address - Fax:
Practice Address - Street 1:2407 W MADISON AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4432
Practice Address - Country:US
Practice Address - Phone:402-860-5478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE839237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist