Provider Demographics
NPI:1932505906
Name:NATION, PENNI (COTA)
Entity Type:Individual
Prefix:
First Name:PENNI
Middle Name:
Last Name:NATION
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7380 CANOSA CT
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-5022
Mailing Address - Country:US
Mailing Address - Phone:303-430-8340
Mailing Address - Fax:303-937-9044
Practice Address - Street 1:7380 CANOSA CT
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-5022
Practice Address - Country:US
Practice Address - Phone:303-430-8340
Practice Address - Fax:303-937-9044
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1016762224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1016762OtherNBCOT