Provider Demographics
NPI:1427164615
Name:TEWES, RENEE A (PT)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:A
Last Name:TEWES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:A
Other - Last Name:ABBOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5790 N 33RD ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-4651
Mailing Address - Country:US
Mailing Address - Phone:402-436-2992
Mailing Address - Fax:402-436-2996
Practice Address - Street 1:6900 A ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4120
Practice Address - Country:US
Practice Address - Phone:402-436-2535
Practice Address - Fax:402-436-2541
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE849225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE650014792OtherMEDICARE(RAILROAD)
NE08758OtherBCBS OF NEBRASKA
NE08758OtherBCBS OF NEBRASKA
NE270757Medicare PIN