Provider Demographics
NPI:1164999371
Name:RAMIREZ, NICOLE M (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:M
Last Name:RAMIREZ
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 1:1062 E 1135 RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-9432
Mailing Address - Country:US
Mailing Address - Phone:785-218-3738
Mailing Address - Fax:
Practice Address - Street 1:811 GROVE ST
Practice Address - Street 2:
Practice Address - City:BALDWIN CITY
Practice Address - State:KS
Practice Address - Zip Code:66006-9204
Practice Address - Country:US
Practice Address - Phone:785-594-2909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01953225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist