Provider Demographics
NPI:1760993604
Name:BRUNS, KELLI (OTR)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:BRUNS
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 1:5505 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2252
Mailing Address - Country:US
Mailing Address - Phone:303-656-5897
Mailing Address - Fax:
Practice Address - Street 1:885 S HIGHWAY 50 BUSINESS LOOP
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:CO
Practice Address - Zip Code:81425-1536
Practice Address - Country:US
Practice Address - Phone:970-323-0370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist