Provider Demographics
NPI:1841711710
Name:KINSEY, NANCY LYNN (OTL)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:LYNN
Last Name:KINSEY
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 STRAND AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-5714
Mailing Address - Country:US
Mailing Address - Phone:406-239-7849
Mailing Address - Fax:
Practice Address - Street 1:3018 RATTLESNAKE DR
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-6101
Practice Address - Country:US
Practice Address - Phone:406-549-0988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-30
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT154225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist