Healthcare Provider Details

I. General information

NPI: 1780423889
Provider Name (Legal Business Name): NATALIYA KIEFER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 GRASSY POND DR
DENNIS MA
02638-2515
US

IV. Provider business mailing address

53 GRASSY POND DR
DENNIS MA
02638-2515
US

V. Phone/Fax

Practice location:
  • Phone: 508-292-1745
  • Fax:
Mailing address:
  • Phone: 508-292-1745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN2325585
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN2325585
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: