Provider Demographics
NPI:1568511186
Name:CRIMMINS, NANCY ANN (MS,PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:CRIMMINS
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39831 NITA DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:IA
Mailing Address - Zip Code:52031-9723
Mailing Address - Country:US
Mailing Address - Phone:563-580-2653
Mailing Address - Fax:
Practice Address - Street 1:4319 NW URBANDALE DR
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7910
Practice Address - Country:US
Practice Address - Phone:515-225-4070
Practice Address - Fax:563-583-4737
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3918225100000X
IA02280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0665950Medicaid
IA166595Medicare ID - Type UnspecifiedGROUP #