Provider Demographics
NPI:1982114393
Name:NUTTING, PATRICIA KELSO
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:KELSO
Last Name:NUTTING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-9364
Mailing Address - Country:US
Mailing Address - Phone:207-650-7643
Mailing Address - Fax:207-781-3724
Practice Address - Street 1:191 FORESIDE RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1768
Practice Address - Country:US
Practice Address - Phone:207-781-4714
Practice Address - Fax:207-781-3724
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1225225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist