Provider Demographics
NPI:1013030428
Name:NETTLES, NATALIE ANN (PT, MS)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:ANN
Last Name:NETTLES
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-9542
Mailing Address - Country:US
Mailing Address - Phone:215-862-3099
Mailing Address - Fax:
Practice Address - Street 1:LOGAN SQUARE
Practice Address - Street 2:SUITE #1
Practice Address - City:NEW HOPE
Practice Address - State:PA
Practice Address - Zip Code:18938
Practice Address - Country:US
Practice Address - Phone:215-862-4195
Practice Address - Fax:215-862-4197
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017670225100000X
NJ40QA01186600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist