Provider Demographics
NPI:1013296417
Name:NOLTING, TASHA JO
Entity Type:Individual
Prefix:MRS
First Name:TASHA
Middle Name:JO
Last Name:NOLTING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 E MCKELVIE RD
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:NE
Mailing Address - Zip Code:68409-3372
Mailing Address - Country:US
Mailing Address - Phone:402-235-3581
Mailing Address - Fax:
Practice Address - Street 1:1420 N 10TH ST
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-1236
Practice Address - Country:US
Practice Address - Phone:402-873-3304
Practice Address - Fax:402-873-6307
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE430225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant