Provider Demographics
NPI:1952429565
Name:HANSEN, KRISTI NICOLE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:NICOLE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:KRISTI
Other - Middle Name:NICOLE
Other - Last Name:HANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1257 SWITCH GRASS DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-4531
Mailing Address - Country:US
Mailing Address - Phone:719-510-0373
Mailing Address - Fax:303-694-9666
Practice Address - Street 1:8200 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 615
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2803
Practice Address - Country:US
Practice Address - Phone:303-694-3333
Practice Address - Fax:303-694-9666
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1038856225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q54999Medicare UPIN
803701Medicare ID - Type Unspecified