MEDICARE: MS. NATALIE SPIF ROMINES SNP

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	363LW0102X	Women's Health Nurse Practitioner	RN150996	GA

General Provider Information

NPI Number	:	1508131905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NATALIE SPIF ROMINES SNP

Provider Business Mailing Address
First Line	:	1520B JENNINGS MILL RD
Second Line	:
City	:	BOGART
State	:	GA
Zip	:	30622-2543
Country	:	US
Telephone Number	:	706-227-8999
Fax Number	:	706-227-6118

Provider Business Practice Location Address
First Line	:	1520B JENNINGS MILL RD
Second Line	:
City	:	BOGART
State	:	GA
Zip	:	30622-2543
Country	:	US
Telephone Number	:	706-227-8999
Fax Number	:	706-227-6118

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

Provider Enumeration Date	:	03/19/2012
Last Update Date	:	03/19/2012

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