Provider Demographics
NPI:1720307838
Name:GRABER, NANCY RUTH (CPTA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:RUTH
Last Name:GRABER
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:RUTH
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPTA
Mailing Address - Street 1:7324 SE 12TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-9640
Mailing Address - Country:US
Mailing Address - Phone:316-283-8537
Mailing Address - Fax:
Practice Address - Street 1:200 W CEDAR ST
Practice Address - Street 2:
Practice Address - City:HESSTON
Practice Address - State:KS
Practice Address - Zip Code:67062-8100
Practice Address - Country:US
Practice Address - Phone:620-327-2544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00135225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant