Healthcare Provider Details

I. General information

NPI: 1407778426
Provider Name (Legal Business Name): ALLIE NICOLE NABITY PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLIE NICOLE DAVIS PTA

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W 17TH ST
SCHUYLER NE
68661-1304
US

IV. Provider business mailing address

104 W 17TH ST
SCHUYLER NE
68661-1304
US

V. Phone/Fax

Practice location:
  • Phone: 402-352-2441
  • Fax:
Mailing address:
  • Phone: 402-352-2441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2159
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: