Provider Demographics
NPI:1649517426
Name:CAVIN, NICOLE BROWN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:BROWN
Last Name:CAVIN
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 1:2701 PICKETT RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5688
Mailing Address - Country:US
Mailing Address - Phone:919-419-9600
Mailing Address - Fax:
Practice Address - Street 1:2701 PICKETT RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5688
Practice Address - Country:US
Practice Address - Phone:919-419-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5877225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist