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

Nicole Ethridge, PTA

Individual provider Physical Therapy Assistant · NPI 1922733484

Nicole Ethridge, PTA is a Physical Therapy Assistant in Flora, Illinois. Licensed in Illinois. Registered with an NPI since 2022.

Licensed in
IL
In the registry since
2022
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

701 Shadwell Ave
Flora, IL 62839-2310
Phone: (618) 662-8361
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X (IL)

Record details

NPI number1922733484
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedJuly 19, 2022
Last updated in NPPESJuly 19, 2022
Certification dateJuly 19, 2022
Mailing address11121 E Candleberry Ave, Effingham, IL 62401-7456

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