Provider Demographics
NPI:1427289651
Name:NUTT, ANNAMARIE BIANCHI
Entity type:Individual
Prefix:MRS
First Name:ANNAMARIE
Middle Name:BIANCHI
Last Name:NUTT
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 1:642 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:IL
Mailing Address - Zip Code:61550-2436
Mailing Address - Country:US
Mailing Address - Phone:309-266-6801
Mailing Address - Fax:309-266-6801
Practice Address - Street 1:642 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:IL
Practice Address - Zip Code:61550-2436
Practice Address - Country:US
Practice Address - Phone:309-266-6801
Practice Address - Fax:309-266-6801
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist