Nicole L Bragan
Individual provider Active NPI Physical Therapy Assistant · Fisherville, VA
NPI 1215415435 · NPPES record last updated Jul 31, 2018
Key facts
- NPI
- 1215415435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2306605035 (VA)
- Practice address
- 83 Crossroad Lane
Fisherville, VA 22939 - Phone
- (540) 885-8424
- NPI assigned
- Jul 31, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 2306605035 | VA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2306605035 | VA | Yes |
Addresses
Primary practice location
83 Crossroad Lane
Fisherville, VA 22939
Mailing address
83 Crossroad Lane
Fisherville, VA 22939
Phone (540) 885-8424
Other providers in Fisherville, VA
- Ahmad Mouayed Abdulmajeed Al-Aloosi
- Thomas Walter Beckman
- Shehzad Alam Khan
- Adam S Rochman
- Ahmed Safiullah Shaikh
- Christopher Wenzinger
All providers in Fisherville, VA · Physical Therapy Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2018. 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.