Healthcare Provider Details

I. General information

NPI: 1033227046
Provider Name (Legal Business Name): ANYA KERKMAN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANYA CARLISLE DPT

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 02/18/2022
Certification Date: 02/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 S 40TH ST STE 200
LINCOLN NE
68506-2411
US

IV. Provider business mailing address

PO BOX 5285
GRAND ISLAND NE
68802-5285
US

V. Phone/Fax

Practice location:
  • Phone: 402-486-3333
  • Fax: 402-486-3349
Mailing address:
  • Phone: 308-675-1853
  • Fax: 308-210-4121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2257
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: