MEDICARE: NATHAN WAYNE NUTTER

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	2255A2300X	Athletic Trainer	AT7931	TX

General Provider Information

NPI Number	:	1821605361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN WAYNE NUTTER

Provider Business Mailing Address
First Line	:	7856 DRUM ST
Second Line	:
City	:	FORT RILEY
State	:	KS
Zip	:	66442-7063
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7856 DRUM ST
Second Line	:
City	:	FORT RILEY
State	:	KS
Zip	:	66442-7063
Country	:	US
Telephone Number	:	620-755-7896
Fax Number	:

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

Provider Enumeration Date	:	09/29/2020
Last Update Date	:	11/24/2025

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Directions to “ NATHAN WAYNE NUTTER ” Practice Location

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