Healthcare Provider Details

I. General information

NPI: 1588150460
Provider Name (Legal Business Name): NATALIE L DUCASTEL CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 MITCHELL PARK DR
PETOSKEY MI
49770-8674
US

IV. Provider business mailing address

211 W LAKE ST
PETOSKEY MI
49770-2312
US

V. Phone/Fax

Practice location:
  • Phone: 231-487-6076
  • Fax:
Mailing address:
  • Phone: 937-248-5991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704343496
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: