Healthcare Provider Details

I. General information

NPI: 1144348004
Provider Name (Legal Business Name): MARIANNE A. NATALI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 WALNUT ST
PHILADELPHIA PA
19107-5001
US

IV. Provider business mailing address

190 NANTMEAL RD.
GLENMOORE PA
19349
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-6996
  • Fax: 215-955-6010
Mailing address:
  • Phone: 215-432-4579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberSP006823B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: