Provider Demographics
NPI:1225337959
Name:LAMBERT, KRISTIN (PTA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 N COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:SUTHERLAND
Mailing Address - State:NE
Mailing Address - Zip Code:69165-7200
Mailing Address - Country:US
Mailing Address - Phone:618-698-4177
Mailing Address - Fax:
Practice Address - Street 1:13609 CALIFORNIA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-5260
Practice Address - Country:US
Practice Address - Phone:402-891-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2080348225200000X
NE925225200000X
MO2010009847225200000X
IL160005421225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant