Provider Demographics
NPI:1770865057
Name:PARTEN, NICOLE LEIGHAN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:LEIGHAN
Last Name:PARTEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:LEIGHAN
Other - Last Name:BOCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:8000 SR 64 E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212
Mailing Address - Country:US
Mailing Address - Phone:941-792-1404
Mailing Address - Fax:941-761-0712
Practice Address - Street 1:8340 LAKEWOOD RANCH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5183
Practice Address - Country:US
Practice Address - Phone:941-792-1404
Practice Address - Fax:941-761-0712
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16596225X00000X, 225X00000X
VA0119004678225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist