Provider Demographics
NPI:1700910023
Name:NANNIZZI CASSITY, ANNETTE K (DC)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:K
Last Name:NANNIZZI CASSITY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:K
Other - Last Name:NANNIZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:8009 W 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4553
Mailing Address - Country:US
Mailing Address - Phone:775-745-0390
Mailing Address - Fax:
Practice Address - Street 1:8009 W 44TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4553
Practice Address - Country:US
Practice Address - Phone:775-745-0390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB783111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV34040Medicare ID - Type Unspecified