Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 11-03836 | KS |
N | 2251S0007X | Physical Therapist - Sports | 11-03836 | KS |
N | 2251X0800X | Physical Therapist - Orthopedic | 11-03836 | KS |
NPI | 1326204793 |
---|---|
Provider Name | Ashley Jean Herrman |
First Address | Overland Park, KS 66210-1599 |
Second Address | Overland Park, KS 66210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2008 |
Last Update Date | 28/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1326472705 | NPI (01) | KS |