Healthcare Provider Details

I. General information

NPI: 1083023931
Provider Name (Legal Business Name): HEATHER NICOLE KALKWARF PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER NICOLE BARBER

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6825 S 27TH ST SUITE 103
LINCOLN NE
68512-4872
US

IV. Provider business mailing address

6825 S 27TH ST SUITE 103
LINCOLN NE
68512-4872
US

V. Phone/Fax

Practice location:
  • Phone: 402-420-0020
  • Fax: 402-420-0014
Mailing address:
  • Phone: 402-420-0020
  • Fax: 402-420-0014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3353
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: