Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1467 | NE |
NPI | 1396014718 |
---|---|
Provider Name | Nicole Marie Sleddens |
First Address | Lincoln, NE 68526-9775 |
Second Address | Syracuse, NE 68446-7017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2011 |
Last Update Date | 14/12/2011 |