=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952345779
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE NATANZON CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2006
-----------------------------------------------------
Last Update Date | 05/04/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1650 HUNTINGDON PIKE SUITE 258
-----------------------------------------------------
City | MEADOWBROOK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19046-8004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-938-9604
-----------------------------------------------------
Fax | 267-728-2137
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1650 HUNTINGDON PIKE SUITE 258
-----------------------------------------------------
City | MEADOWBROOK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19046-8004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-938-9604
-----------------------------------------------------
Fax | 267-728-2137
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | SP008991
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------