Provider Demographics
NPI:1225242589
Name:CRIPPEN, NICOLE M (OTR)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:M
Last Name:CRIPPEN
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 1:5409 S GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-7403
Mailing Address - Country:US
Mailing Address - Phone:303-345-8688
Mailing Address - Fax:
Practice Address - Street 1:5409 S GARRISON ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7403
Practice Address - Country:US
Practice Address - Phone:303-345-8688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1013920225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO34083553Medicaid