Healthcare Provider Details

I. General information

NPI: 1306007869
Provider Name (Legal Business Name): NATALIE IMBIER LNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 W STAFFORD RD # III
STAFFORD SPRINGS CT
06076-1000
US

IV. Provider business mailing address

72 W STAFFORD RD # III
STAFFORD SPRINGS CT
06076-1000
US

V. Phone/Fax

Practice location:
  • Phone: 860-684-5770
  • Fax:
Mailing address:
  • Phone: 860-684-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number000225
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN142756
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: