Individual
TRICIA L HULTGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
909 N 96 ST, SUITE 201, OMAHA, NE 68114-2508
(402) 330-4555
(402) 330-4626
Mailing address
909 N 96 ST, SUITE 201, OMAHA, NE 68114-2508
(402) 330-4555
(402) 330-4626
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25707
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100255555000
—
NE
Enumeration date
05/09/2007
Last updated
10/08/2012
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