Provider Demographics
NPI:1871619874
Name:BRACE, ROBIN RENEE (CPTA)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:RENEE
Last Name:BRACE
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WESGAYE ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-7849
Mailing Address - Country:US
Mailing Address - Phone:402-332-4561
Mailing Address - Fax:
Practice Address - Street 1:323 S 132ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2106
Practice Address - Country:US
Practice Address - Phone:402-330-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE449225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant