Provider Demographics
NPI:1851191274
Name:GIESECKE, ABIGAIL JANE (ATS, NREMT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:JANE
Last Name:GIESECKE
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Gender:
Credentials:ATS, NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:505 PEBBLE BEACH CT
Mailing Address - Street 2:
Mailing Address - City:POPLAR GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:61065-7804
Mailing Address - Country:US
Mailing Address - Phone:815-978-6019
Mailing Address - Fax:
Practice Address - Street 1:800 W STADIUM AVE
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47907-2046
Practice Address - Country:US
Practice Address - Phone:765-494-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer