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General NPI Number Information
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NPI Number | 1891007563
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Entity Type | Individual
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Provider Name | AMANDA KAYE PUEPPKE DPT
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Gender | Female
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 05/30/2015
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Provider Practice Location Address
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Address Line | 10601 S 72ND ST STE. 103
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City | PAPILLION
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State | NE
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Zip | 68046-3407
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Country | US
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Telephone | 402-932-2782
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Fax | 402-932-2705
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Provider Business Mailing Address
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Address Line | 10601 S 72ND ST STE. 103
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City | PAPILLION
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State | NE
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Zip | 68046-3407
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Country | US
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Telephone | 402-932-2782
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Fax | 402-932-2705
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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 | 2897
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License Number State | NE
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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 | 004635
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License Number State | IA
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