Provider Demographics
NPI:1922294818
Name:SIKES, NANCY ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ELIZABETH
Last Name:SIKES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:SIKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:139 MAPLE ROW BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3853
Mailing Address - Country:US
Mailing Address - Phone:615-826-7113
Mailing Address - Fax:615-826-7139
Practice Address - Street 1:139 MAPLE ROW BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3853
Practice Address - Country:US
Practice Address - Phone:615-826-7113
Practice Address - Fax:615-826-7139
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT0000001438225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN9777290OtherAETNA
TN4157450OtherBCBS
TN1501343Medicaid