Stacey Rae Stuertz, PTA
Individual provider Active NPI Physical Therapy Assistant · Fairmont, NE
NPI 1114589207 · NPPES record last updated Jun 28, 2019
Key facts
- NPI
- 1114589207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 982 (NE)
- Practice address
- 740 12TH Ave
Fairmont, NE 68354-9593 - Phone
- (402) 366-6950
- NPI assigned
- Jun 28, 2019
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 982 | NE | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 982 | NE | Yes |
Addresses
Primary practice location
740 12TH Ave
Fairmont, NE 68354-9593
Mailing address
740 12TH Ave
Fairmont, NE 68354-9593
Phone (402) 366-6950
Other providers in Fairmont, NE
- City of Fairmont Nebraska - Fairview Manor
- City of Fairmont Nebraska - Fairview Manor Dba Country Reflections
- Jennifer Lynn Glenn
- Tracy L Post
- Angela D Schurmann
- Village of Fairmont
- Abby Leigh Walters
All providers in Fairmont, NE · Physical Therapy Assistant in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.