Provider Demographics
NPI:1043273998
Name:DENNEN, NATALIE (ATC, PA-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:DENNEN
Suffix:
Gender:F
Credentials:ATC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SEAGATE # 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:419-291-1420
Mailing Address - Fax:419-214-3841
Practice Address - Street 1:3316 NAVARRE AVE STE F
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3301
Practice Address - Country:US
Practice Address - Phone:419-291-1420
Practice Address - Fax:419-214-3841
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAT3412255A2300X
MEPA1702363A00000X
OH50.006254RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer