Healthcare Provider Details

I. General information

NPI: 1205754447
Provider Name (Legal Business Name): ASHLEY ANN BOHANNON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

312 N OAKLAND AVE
OAKLAND NE
68045-1196
US

IV. Provider business mailing address

24055 430 ST
HUMPHREY NE
68642-5053
US

V. Phone/Fax

Practice location:
  • Phone: 402-685-4499
  • Fax:
Mailing address:
  • Phone: 402-685-4499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4973
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: