MEDICARE: NATALIE EVANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach	114677703	FL

General Provider Information

NPI Number	:	1497565451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE EVANS

Provider Business Mailing Address
First Line	:	4326 KERRIGAN CIR
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33953-5909
Country	:	US
Telephone Number	:	682-288-1207
Fax Number	:

Provider Business Practice Location Address
First Line	:	4326 KERRIGAN CIR
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33953-5909
Country	:	US
Telephone Number	:	682-288-1207
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2025
Last Update Date	:	01/14/2025

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Directions to “ NATALIE EVANS ” Practice Location

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