Provider Demographics
NPI:1639325145
Name:NUTTER, ALLORA NICOLE (OTR)
Entity Type:Individual
Prefix:
First Name:ALLORA
Middle Name:NICOLE
Last Name:NUTTER
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 1:8033 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2249
Mailing Address - Country:US
Mailing Address - Phone:826-268-1940
Mailing Address - Fax:
Practice Address - Street 1:8033 MADISON AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2249
Practice Address - Country:US
Practice Address - Phone:826-268-1940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02257225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17-02257OtherSTATE LISCENSE