Provider Demographics
NPI:1619232147
Name:HEINERT, NIKKI (MS, OT)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:HEINERT
Suffix:
Gender:F
Credentials:MS, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 ALBANY CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4139
Mailing Address - Country:US
Mailing Address - Phone:970-690-8004
Mailing Address - Fax:
Practice Address - Street 1:2205 ALBANY CT
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4139
Practice Address - Country:US
Practice Address - Phone:970-690-8004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0003478225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist