Provider Demographics
NPI:1538331764
Name:JOHNS, NIKOLE RENEE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:NIKOLE
Middle Name:RENEE
Last Name:JOHNS
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 1:1250 REEVES DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-9649
Mailing Address - Country:US
Mailing Address - Phone:970-204-0034
Mailing Address - Fax:
Practice Address - Street 1:508 W TRILBY RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4054
Practice Address - Country:US
Practice Address - Phone:970-223-3922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist