Penni Jo Romero, P.T., M.S

Individual provider Active NPI Pediatric Physical Therapist · Elkhorn, NE

NPI 1104949833 · NPPES record last updated Feb 21, 2014

Key facts

NPI
1104949833
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Physical Therapist 2251P0200X
License
620 (NE)
Practice address
3460 Piney Creek Dr
Elkhorn, NE 68022-4420
Phone
(402) 289-0053
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
620NEMDPediatric Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 620 NE Yes

Addresses

Primary practice location

3460 Piney Creek Dr
Elkhorn, NE 68022-4420

Mailing address

3460 Piney Creek Dr
Elkhorn, NE 68022-4420
Phone (402) 289-0053

Other identifiers

IdentifierTypeStateIssuer
10025210600MedicaidNE

Other providers in Elkhorn, NE

All providers in Elkhorn, NE · Pediatric Physical Therapist in Nebraska

Sources for this page

Verify at the official NPI Registry.