MEDICARE: STEPHANIE ANNE NATSON

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	171W00000X	Contractor	1683416	TX

General Provider Information

NPI Number	:	1891073219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ANNE NATSON

Provider Business Mailing Address
First Line	:	6937 NE LOOP 820
Second Line	:	1518
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-9041
Country	:	US
Telephone Number	:	817-709-5049
Fax Number	:

Provider Business Practice Location Address
First Line	:	6937 NE LOOP 820
Second Line	:	1518
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-9041
Country	:	US
Telephone Number	:	817-709-5049
Fax Number	:

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

Provider Enumeration Date	:	08/02/2011
Last Update Date	:	08/02/2011

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