Provider Demographics
NPI:1902268295
Name:BRANGERS, AMY NORDMANN (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:NORDMANN
Last Name:BRANGERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:NORDMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3116 BRECKENRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-2709
Mailing Address - Country:US
Mailing Address - Phone:502-479-7709
Mailing Address - Fax:502-479-7706
Practice Address - Street 1:3116 BRECKENRIDGE LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2709
Practice Address - Country:US
Practice Address - Phone:502-479-7709
Practice Address - Fax:502-479-7706
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT002275225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist