Provider Demographics
NPI:1417590530
Name:PRUE, KIRSTEN (OTR)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:PRUE
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 1:1935 N LOGAN ST APT 1030
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4440
Mailing Address - Country:US
Mailing Address - Phone:802-371-7913
Mailing Address - Fax:
Practice Address - Street 1:1935 N LOGAN ST APT 1030
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4440
Practice Address - Country:US
Practice Address - Phone:207-409-6537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist