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

Jenna Marie St Nicholas, PTA

Individual provider Physical Therapy Assistant · NPI 1053891002

Jenna Marie St Nicholas, PTA is a Physical Therapy Assistant in Kilgore, Texas. Practices as a sole proprietor and works from 2 locations. Licensed in Texas.

Licensed in
TX
In the registry since
2018
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

1100 Broadway Blvd
Kilgore, TX 75662-3204
Phone: (903) 983-8209
Show map & directions

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

Additional practice locations (1)

  • 2131 Alpine Rd, Longview, TX 75601-3402 — (903) 757-8786

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2090656 (TX)

Record details

NPI number1053891002
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedAugust 20, 2018
Last updated in NPPESAugust 20, 2018

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