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General NPI Number Information
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NPI Number | 1497243729
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Entity Type | Individual
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Provider Name | NICOLE NASH LOTR
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Gender | Female
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 330 FALCONER DR STE D
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City | COVINGTON
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State | LA
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Zip | 70433-8211
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Country | US
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Telephone | 985-900-2305
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Fax |
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Provider Business Mailing Address
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Address Line | 472 E HONORS POINT CT
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City | SLIDELL
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State | LA
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Zip | 70458-5781
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Country | US
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Telephone | 504-481-3142
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | Z12075
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License Number State | LA
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