Provider Demographics
NPI:1003042359
Name:DROBNICK, NANETTE SUSAN (OTR)
Entity Type:Individual
Prefix:MS
First Name:NANETTE
Middle Name:SUSAN
Last Name:DROBNICK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 PRINTERS PKWY
Mailing Address - Street 2:SECOND SIGHT
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3190
Mailing Address - Country:US
Mailing Address - Phone:719-329-7171
Mailing Address - Fax:
Practice Address - Street 1:340 PRINTERS PKWY
Practice Address - Street 2:SECOND SIGHT
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3190
Practice Address - Country:US
Practice Address - Phone:719-329-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1001788OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY, INC.
CO1306OtherDEPARTMENT OF REGULATORY AGENCIES, DIVISION OF REGISTRATIONS