Provider Demographics
NPI:1902463896
Name:ATKINS, KATIE NICOLE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:NICOLE
Last Name:ATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54742 853 RD
Mailing Address - Street 2:
Mailing Address - City:PIERCE
Mailing Address - State:NE
Mailing Address - Zip Code:68767-3619
Mailing Address - Country:US
Mailing Address - Phone:402-649-8837
Mailing Address - Fax:
Practice Address - Street 1:9225 CASCADE AVE
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8592
Practice Address - Country:US
Practice Address - Phone:515-978-2395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-25
Last Update Date:2019-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist