Provider Demographics
NPI:1245531565
Name:ALBERTS, SUSAN E (PT)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:E
Last Name:ALBERTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1408 VETERANS DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-6912
Mailing Address - Country:US
Mailing Address - Phone:402-289-3288
Mailing Address - Fax:402-289-2550
Practice Address - Street 1:1408 VETERANS DR
Practice Address - Street 2:SUITE 102
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-6912
Practice Address - Country:US
Practice Address - Phone:402-289-3288
Practice Address - Fax:402-289-2550
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE2916225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEP00998325OtherRR MEDICARE
NE098958013Medicare PIN