Provider Demographics
NPI:1740523679
Name:FRICKEL, MEGAN ROXANNE (DPT)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ROXANNE
Last Name:FRICKEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ROXANNE
Other - Last Name:RING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:624 W LEOTA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6532
Mailing Address - Country:US
Mailing Address - Phone:308-534-5590
Mailing Address - Fax:308-534-5570
Practice Address - Street 1:624 W LEOTA ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6532
Practice Address - Country:US
Practice Address - Phone:308-534-5590
Practice Address - Fax:308-534-5570
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2869225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGOtherPENDING