Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3621 | NE |
N | 2251G0304X | Physical Therapist - Geriatrics |
NPI | 1013468123 |
---|---|
Provider Name | Mrs. Ann Elizabeth Kastrup |
First Address | Norfolk, NE 68701-2609 |
Second Address | Papillion, NE 68046-2548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2016 |
Last Update Date | 14/04/2021 |