Provider Demographics
NPI:1245693662
Name:NANNEY, JENIFER ERIN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:JENIFER
Middle Name:ERIN
Last Name:NANNEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2798 MACON WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-4009
Mailing Address - Country:US
Mailing Address - Phone:601-486-3357
Mailing Address - Fax:
Practice Address - Street 1:2798 MACON WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-4009
Practice Address - Country:US
Practice Address - Phone:601-486-3357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-02
Last Update Date:2016-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0004296225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist