Provider Demographics
NPI:1932277712
Name:NEVINS, CHRISTY LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LYNN
Last Name:NEVINS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 ROYAL
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-8744
Mailing Address - Country:US
Mailing Address - Phone:816-476-4011
Mailing Address - Fax:816-476-4015
Practice Address - Street 1:6600 ROYAL
Practice Address - Street 2:
Practice Address - City:PLEASANT VALLEY
Practice Address - State:MO
Practice Address - Zip Code:64068-8744
Practice Address - Country:US
Practice Address - Phone:816-476-4011
Practice Address - Fax:816-476-4015
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000155790225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist