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NPI Code Detail

MEDICARE: MRS. NATALIE R GILLIS CRNP

MEDICARE: MRS. NATALIE R GILLIS CRNP
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
1363LF0000XFamily Nurse PractitionerTP006082BPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669467627
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NATALIE R GILLIS CRNP
Provider Business Mailing Address
First Line : 409 S 2ND ST STE 2F
Second Line :
City : HARRISBURG
State : PA
Zip : 17104-1612
Country : US
Telephone Number : 717-988-0000
Fax Number : 717-782-5716
Provider Business Practice Location Address
First Line : 111 S FRONT ST
Second Line :
City : HARRISBURG
State : PA
Zip : 17101-2010
Country : US
Telephone Number : 717-988-0000
Fax Number : 717-782-5716
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 01/02/2021

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