Healthcare Provider Details

I. General information

NPI: 1194543686
Provider Name (Legal Business Name): NATALIE OLTEAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N PERRY ST
PONTIAC MI
48342-2217
US

IV. Provider business mailing address

2901 TURKEY RUN ST
ROCHESTER MI
48306-1257
US

V. Phone/Fax

Practice location:
  • Phone: 248-338-5824
  • Fax: 248-338-5547
Mailing address:
  • Phone: 248-390-9479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704342711
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: