Provider Demographics
NPI:1306283510
Name:STINMAN, ANGELA A (PTA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:A
Last Name:STINMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:10601 S 72ND ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3408
Mailing Address - Country:US
Mailing Address - Phone:402-932-2782
Mailing Address - Fax:402-932-2705
Practice Address - Street 1:10601 S 72ND ST STE 103
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3408
Practice Address - Country:US
Practice Address - Phone:402-932-2782
Practice Address - Fax:402-932-2705
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1140225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant