Provider Demographics
NPI:1326287384
Name:NORD, ANNE CATHERINE (MOTR)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:CATHERINE
Last Name:NORD
Suffix:
Gender:F
Credentials:MOTR
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:CATHERINE
Other - Last Name:PARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR
Mailing Address - Street 1:3613 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-7253
Mailing Address - Country:US
Mailing Address - Phone:920-458-4040
Mailing Address - Fax:
Practice Address - Street 1:3613 S 13TH ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-7253
Practice Address - Country:US
Practice Address - Phone:920-458-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4734026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist