Provider Demographics
NPI:1710742663
Name:NAKAYAMA, KRISTYN (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:
Last Name:NAKAYAMA
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 CORNHUSKER HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-1509
Mailing Address - Country:US
Mailing Address - Phone:402-904-4474
Mailing Address - Fax:402-318-3154
Practice Address - Street 1:3940 CORNHUSKER HWY STE 200
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-1509
Practice Address - Country:US
Practice Address - Phone:402-904-4474
Practice Address - Fax:402-318-3154
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2889225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist