Healthcare Provider Details

I. General information

NPI: 1073306262
Provider Name (Legal Business Name): NATALIE JOAN FERRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1597 DELMAR CIR
IDAHO FALLS ID
83404-7400
US

IV. Provider business mailing address

4700 N KOLB RD APT 11108
TUCSON AZ
85750-6175
US

V. Phone/Fax

Practice location:
  • Phone: 501-547-4520
  • Fax:
Mailing address:
  • Phone: 501-547-4520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number4571161
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: