MEDICARE: CHRISTY LYNN NEVINS OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	2000155790	MO

General Provider Information

NPI Number	:	1932277712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY LYNN NEVINS OTR

Provider Business Mailing Address
First Line	:	6600 ROYAL
Second Line	:
City	:	PLEASANT VALLEY
State	:	MO
Zip	:	64068-8744
Country	:	US
Telephone Number	:	816-476-4011
Fax Number	:	816-476-4015

Provider Business Practice Location Address
First Line	:	6600 ROYAL
Second Line	:
City	:	PLEASANT VALLEY
State	:	MO
Zip	:	64068-8744
Country	:	US
Telephone Number	:	816-476-4011
Fax Number	:	816-476-4015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	07/08/2007

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