Provider Demographics
NPI:1164690087
Name:TOMANELLI, NANCY (OTR/L)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:TOMANELLI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9927 FIELDCREST DR
Mailing Address - Street 2:
Mailing Address - City:APISON
Mailing Address - State:TN
Mailing Address - Zip Code:37302-7576
Mailing Address - Country:US
Mailing Address - Phone:423-827-4835
Mailing Address - Fax:
Practice Address - Street 1:9927 FIELDCREST DR
Practice Address - Street 2:
Practice Address - City:APISON
Practice Address - State:TN
Practice Address - Zip Code:37302-7576
Practice Address - Country:US
Practice Address - Phone:423-827-4835
Practice Address - Fax:423-600-0156
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT0000002383225XP0200X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1164690087Medicaid