Provider Demographics
NPI:1700883766
Name:BARTELS, BETH G (PT)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:G
Last Name:BARTELS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11336 S 96TH ST
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4209
Mailing Address - Country:US
Mailing Address - Phone:402-315-3603
Mailing Address - Fax:402-315-3604
Practice Address - Street 1:11336 S 96TH ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4209
Practice Address - Country:US
Practice Address - Phone:402-315-3603
Practice Address - Fax:402-315-3604
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-06
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE841225100000X
IA01481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025656400Medicaid
NENA1131001Medicare PIN