Provider Demographics
NPI:1508025560
Name:CLASSEN, TAMMY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:CLASSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 S 83RD ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5972
Mailing Address - Country:US
Mailing Address - Phone:402-327-0310
Mailing Address - Fax:
Practice Address - Street 1:4735 S 54TH ST
Practice Address - Street 2:REHABILITATION DEPT ATTN : JENNIFER TEGTMEIER
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-1335
Practice Address - Country:US
Practice Address - Phone:402-488-0977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1350225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist