Provider Demographics
NPI:1992895528
Name:HUSTON, DARREN WAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:WAYNE
Last Name:HUSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:NE
Mailing Address - Zip Code:68788-1258
Mailing Address - Country:US
Mailing Address - Phone:402-372-3448
Mailing Address - Fax:402-372-3448
Practice Address - Street 1:836 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NE
Practice Address - Zip Code:68788-1258
Practice Address - Country:US
Practice Address - Phone:402-372-3448
Practice Address - Fax:402-372-3448
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025302800Medicaid
270785Medicare ID - Type Unspecified
09630Medicare UPIN