Provider Demographics
NPI:1184793820
Name:MULLIGAN, NANCY FORD (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:FORD
Last Name:MULLIGAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 BASELINE RD
Mailing Address - Street 2:SUITE D 107
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2699
Mailing Address - Country:US
Mailing Address - Phone:303-499-6818
Mailing Address - Fax:
Practice Address - Street 1:4800 BASELINE RD
Practice Address - Street 2:SUITE D 107
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2699
Practice Address - Country:US
Practice Address - Phone:303-499-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3073225100000X, 2251E1200X, 2251G0304X, 2251H1200X, 2251N0400X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC811082OtherMEDICARE PIN