MEDICARE: NATALIE TUCKER BARNES MS, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	U1-0001122	DE
2	225X00000X	Occupational Therapist	12-0266	NV

General Provider Information

NPI Number	:	1134352461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE TUCKER BARNES MS, OTR/L

Provider Business Mailing Address
First Line	:	7840 RHODORA PEAK ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-5212
Country	:	US
Telephone Number	:	702-444-0774
Fax Number	:

Provider Business Practice Location Address
First Line	:	9550 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8038
Country	:	US
Telephone Number	:	702-444-0774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2009
Last Update Date	:	06/29/2016

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