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NPI Code Detail

MEDICARE: RHIANNON HERSTEDT

MEDICARE: RHIANNON HERSTEDT
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
1225200000XPhysical Therapy Assistant1902NE

General Provider Information

NPI Number : 1720664964
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHIANNON HERSTEDT
Provider Business Mailing Address
First Line : 1000 HESPE DR APT 102
Second Line :
City : NORFOLK
State : NE
Zip : 68701-2864
Country : US
Telephone Number : 308-760-4854
Fax Number :
Provider Business Practice Location Address
First Line : 4715 38TH ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-1622
Country : US
Telephone Number : 402-942-9260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2021
Last Update Date : 03/18/2021

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Directions to “ RHIANNON HERSTEDT ” Practice Location

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