Provider Demographics
NPI:1588546394
Name:NEBGEN, ERIN MICHELLE (PTA)
Entity type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:MICHELLE
Last Name:NEBGEN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 WALTERS LN
Mailing Address - Street 2:
Mailing Address - City:CRESSON
Mailing Address - State:PA
Mailing Address - Zip Code:16630-1096
Mailing Address - Country:US
Mailing Address - Phone:814-318-4189
Mailing Address - Fax:
Practice Address - Street 1:1516 9TH AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2417
Practice Address - Country:US
Practice Address - Phone:814-889-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE012986225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant