MEDICARE: MS. KAREN M STILLE PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	784	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	650017043	OTHER	NE	MEDICARE (RAILROAD)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	39697	OTHER	NE	BCBS OF NEBRASKA

General Provider Information

NPI Number	:	1508972795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN M STILLE PT

Provider Business Mailing Address
First Line	:	1651 N 86TH ST STE 100
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-3719
Country	:	US
Telephone Number	:	402-484-7117
Fax Number	:	402-484-7118

Provider Business Practice Location Address
First Line	:	1409 SILVER ST
Second Line	:
City	:	ASHLAND
State	:	NE
Zip	:	68003-1845
Country	:	US
Telephone Number	:	402-944-3505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	12/03/2018

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Directions to “ MS. KAREN M STILLE PT” Practice Location

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