Provider Demographics
NPI:1043517386
Name:AVERY, NATALIE M (FNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:AVERY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 BURKARTH RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-3103
Mailing Address - Country:US
Mailing Address - Phone:660-747-7751
Mailing Address - Fax:660-747-8398
Practice Address - Street 1:513 BURKARTH RD
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-3103
Practice Address - Country:US
Practice Address - Phone:660-747-7751
Practice Address - Fax:660-747-8398
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011003875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily