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General NPI Number Information
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NPI Number | 1730903378
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Entity Type | Individual
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Provider Name | KATHRYN KRISTY HERGENROTHER DPT
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Gender |
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 9109 BLONDO ST STE 2
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City | OMAHA
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State | NE
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Zip | 68134-6100
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Country | US
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Telephone | 402-399-9993
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Fax |
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Provider Business Mailing Address
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Address Line | 4131 KENSINGTON AVE
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City | EVANSVILLE
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State | IN
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Zip | 47710-3742
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Country | US
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Telephone | 812-598-0919
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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 | 05015664A
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License Number State | IN
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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 | 4872
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License Number State | NE
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