Nicole Brown
Individual provider Active NPI Occupational Therapist · Farmington, MO
NPI 1992167803 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1992167803
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 2015044228 (MO)
- Practice address
- 2950 H Hwy
Farmington, MO 63640-7047 - Phone
- (573) 330-7047
- NPI assigned
- Mar 22, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015044228 | MO | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician | 374700000X | |||
| Occupational Therapist | 225X00000X | 2015044228 | MO | Yes |
Addresses
Primary practice location
2950 H Hwy
Farmington, MO 63640-7047
Mailing address
3863 Cleveland Ave
Saint Louis, MO 63110-4009
Phone (314) 664-3927
Other practice location 1
3863 Cleveland Ave
Saint Louis, MO 63110-4009
Phone (314) 664-3927
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2015044228 | Other | MO | STATE OF MISSOURI |
Other providers in Farmington, MO
- Brookside Manor Residential Care, LLC
- Margaret J Brothers
- Kelly Jeanne Brotherton
- Janet M Brown
- Jennifer Brown
- Victor M Brown
- Lisa Marie Bruemmer
- Kylee Nicole Brueschke
- Lori Nicole Bryan
- Monica N Bryan
All providers in Farmington, MO · Occupational Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.