Provider Demographics
NPI:1386431393
Name:HUME, JODY R
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:R
Last Name:HUME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11562 US HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-3010
Mailing Address - Country:US
Mailing Address - Phone:308-249-3195
Mailing Address - Fax:
Practice Address - Street 1:11562 US HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-3010
Practice Address - Country:US
Practice Address - Phone:308-249-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty