Provider Demographics
NPI:1366980716
Name:KORTE, NICOLE CELESTE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:CELESTE
Last Name:KORTE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:CELESTE
Other - Last Name:KRUSCHWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:9139 RIDGELINE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2333
Mailing Address - Country:US
Mailing Address - Phone:720-777-2639
Mailing Address - Fax:
Practice Address - Street 1:9139 RIDGELINE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2333
Practice Address - Country:US
Practice Address - Phone:720-777-2639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001139225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics