Provider Demographics
NPI:1730467689
Name:DONTIGNEY, NICOLLE (PTA)
Entity Type:Individual
Prefix:MS
First Name:NICOLLE
Middle Name:
Last Name:DONTIGNEY
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 1:15301 GREENE AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-3335
Mailing Address - Country:US
Mailing Address - Phone:402-304-4060
Mailing Address - Fax:
Practice Address - Street 1:12856 DEAUVILLE DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3204
Practice Address - Country:US
Practice Address - Phone:402-895-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1027225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant