Provider Demographics
NPI:1841344405
Name:KAUFMAN, NANCY PLUMLEY (PT)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:PLUMLEY
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:CAROL
Other - Last Name:PLUMLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1929 LINDEN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-2281
Mailing Address - Country:US
Mailing Address - Phone:307-630-3003
Mailing Address - Fax:
Practice Address - Street 1:1929 LINDEN RIDGE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2281
Practice Address - Country:US
Practice Address - Phone:307-630-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY257225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY257Medicaid