Stacey Kim Hummel, PTA
Individual provider Active NPI Physical Therapy Assistant · Bremen, IN
NPI 1467968602 · NPPES record last updated Dec 26, 2017
Key facts
- NPI
- 1467968602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 06003185A (IN)
- Practice address
- 316 Woodies LN
Bremen, IN 46506-1354 - Phone
- (574) 546-3494
- NPI assigned
- Dec 26, 2017
- 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 |
|---|---|---|---|
| 06003185A | IN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 06003185A | IN | Yes |
Addresses
Primary practice location
316 Woodies LN
Bremen, IN 46506-1354
Mailing address
324 Burket LN
Bremen, IN 46506-1977
Other providers in Bremen, IN
- Jesse Robert Gettinger
- Paul R. Gettinger
- Lensa Gideon Girsha
- Hearing Diagnostics Center
- Hook-Superx LLC
- Alyssa Ingle
- Jackson County Schneck Memorial Hospital
- Graciela Jimenez-Martinez
- Kevin R Hickman
- Robert Blaine Kolbe Jr.
All providers in Bremen, IN · Physical Therapy Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2017. 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.