Healthcare Provider Details

I. General information

NPI: 1770404915
Provider Name (Legal Business Name): NATALIE MCGOVERN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 W ANTHEM WAY UNIT 3025
ANTHEM AZ
85086-3142
US

IV. Provider business mailing address

3825 W ANTHEM WAY UNIT 3025
ANTHEM AZ
85086-3142
US

V. Phone/Fax

Practice location:
  • Phone: 480-221-9457
  • Fax:
Mailing address:
  • Phone: 480-221-9457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MS. NATALIE ANN MCGOVERN
Title or Position: OWNER
Credential:
Phone: 480-221-9457