MEDICARE: NATALIE FOX RD

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	133V00000X	Registered Dietitian	DI1547	ME

General Provider Information

NPI Number	:	1437762036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE FOX RD

Provider Business Mailing Address
First Line	:	PO BOX 865
Second Line	:
City	:	CONWAY
State	:	NH
Zip	:	03818-0865
Country	:	US
Telephone Number	:	530-205-5605
Fax Number	:

Provider Business Practice Location Address
First Line	:	693 BOLSTERS MILLS RD
Second Line	:
City	:	HARRISON
State	:	ME
Zip	:	04040-3806
Country	:	US
Telephone Number	:	530-205-5605
Fax Number	:

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

Provider Enumeration Date	:	08/25/2020
Last Update Date	:	08/17/2023

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