Healthcare Provider Details

I. General information

NPI: 1841110244
Provider Name (Legal Business Name): MAGEN JORGENSEN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2585 HENDERSONVILLE RD
ARDEN NC
28704-9577
US

IV. Provider business mailing address

2923 SYLVAN RD
NEBRASKA CITY NE
68410-3386
US

V. Phone/Fax

Practice location:
  • Phone: 402-637-9688
  • Fax:
Mailing address:
  • Phone: 402-637-9688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1991
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: