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General NPI Number Information
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NPI Number | 1184865677
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Entity Type | Individual
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Provider Name | NICOLE C HIMMELMAN
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Gender | Female
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Dates
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Enumeration Date | 03/13/2009
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 765 W GRANT ST
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City | PLANT CITY
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State | FL
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Zip | 33563-6810
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Country | US
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Telephone | 813-743-3701
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Fax |
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Provider Business Mailing Address
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Address Line | 16412 BRIDGEWALK DR
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City | LITHIA
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State | FL
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Zip | 33547-4822
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Country | US
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Telephone | 501-772-7110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT2908
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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