Provider Demographics
NPI:1376834879
Name:NEVINS, KAREN LYNN (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:NEVINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18112
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80308-1112
Mailing Address - Country:US
Mailing Address - Phone:303-877-4282
Mailing Address - Fax:303-443-3453
Practice Address - Street 1:3865 BIRCHWOOD DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1428
Practice Address - Country:US
Practice Address - Phone:303-877-4282
Practice Address - Fax:303-443-3453
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist