Provider Demographics
NPI:1871700419
Name:FOX, NICOLE ELLEN (DPT)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:ELLEN
Last Name:FOX
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10710 WESTMINSTER BLVD UNIT 120
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80020-4182
Mailing Address - Country:US
Mailing Address - Phone:303-593-0696
Mailing Address - Fax:720-920-9430
Practice Address - Street 1:1 SUPERIOR DR UNIT B
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8649
Practice Address - Country:US
Practice Address - Phone:720-388-8380
Practice Address - Fax:720-920-9430
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPT 11732225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO267033YM65Medicare PIN