Provider Demographics
NPI:1386262087
Name:POPPEN, ABIGAYLE
Entity type:Individual
Prefix:
First Name:ABIGAYLE
Middle Name:
Last Name:POPPEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABIGAYLE
Other - Middle Name:
Other - Last Name:PREISSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:702 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-7321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4510 E 56TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-4118
Practice Address - Country:US
Practice Address - Phone:308-865-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4071225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist