Individual
TARA NANNINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
4911 N 26TH ST STE 100, LINCOLN, NE 68521-4739
(402) 477-3110
(402) 477-4990
Mailing address
4911 N 26TH ST STE 100, LINCOLN, NE 68521-4739
(402) 477-3110
(402) 477-4990
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1720
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-06260
STATE OF KANSAS
KS
01
—
1720
STATE OF NE
NE
01
—
2019010863
STATE OF MISSOURI
MO
Enumeration date
02/09/2011
Last updated
07/20/2020
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