Provider Demographics
NPI:1225326648
Name:WHITE, ERIKA (DPT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:HADENFELDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2707 L ST
Mailing Address - Street 2:
Mailing Address - City:ORD
Mailing Address - State:NE
Mailing Address - Zip Code:68862-1275
Mailing Address - Country:US
Mailing Address - Phone:308-728-4247
Mailing Address - Fax:308-728-5840
Practice Address - Street 1:2707 L ST
Practice Address - Street 2:
Practice Address - City:ORD
Practice Address - State:NE
Practice Address - Zip Code:68862-1275
Practice Address - Country:US
Practice Address - Phone:308-728-4247
Practice Address - Fax:308-728-5840
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2992225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2992OtherSTATE LICENSE
NENA1714004,086994023OtherPTAN