Provider Demographics
NPI:1992316186
Name:INGEL, NICOLETTE RAE (PHYSICAL THERAPY)
Entity type:Individual
Prefix:
First Name:NICOLETTE
Middle Name:RAE
Last Name:INGEL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 WILFORD HALL LOOP BLDG 4554
Mailing Address - Street 2:
Mailing Address - City:JBSA LACKLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78236-5638
Mailing Address - Country:US
Mailing Address - Phone:210-292-5040
Mailing Address - Fax:
Practice Address - Street 1:8TH MEDICAL GROUP
Practice Address - Street 2:UNIT 2022
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96264-2022
Practice Address - Country:US
Practice Address - Phone:412-992-8842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20105225100000X
PADAPT005450225100000X
PAPT028694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist