Provider Demographics
NPI:1912253204
Name:FELIKSA, NICOLE LYNN (PT)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:LYNN
Last Name:FELIKSA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 LYLA LN
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-9204
Mailing Address - Country:US
Mailing Address - Phone:406-826-8413
Mailing Address - Fax:
Practice Address - Street 1:12 MT HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:MT
Practice Address - Zip Code:59859-9601
Practice Address - Country:US
Practice Address - Phone:406-826-4383
Practice Address - Fax:406-826-4394
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22752251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic