Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shane Nissen

Individual provider Physical Therapist · NPI 1629316369

Dr. Shane Nissen is a Physical Therapist in Carroll, Iowa. Practices as a sole proprietor. Licensed in Arizona and Iowa.

Licensed in
AZ, IA
In the registry since
2013
Specialties on file
2

Practice location Address checks out

629 Granada Rd
Carroll, IA 51401-1709
Phone: (712) 210-2147
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 004889 (IA)
Physical Therapist Taxonomy 225100000X · Licence 9706 (AZ)

Record details

NPI number1629316369
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 30, 2013
Last updated in NPPESJanuary 30, 2013
Mailing address629 Granada Rd, Carroll, IA 51401-1709

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