Provider Demographics
NPI:1083927594
Name:LEGLER, NATALIE (LPN)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:LEGLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 CHURTON RD
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:13476-4611
Mailing Address - Country:US
Mailing Address - Phone:315-729-2742
Mailing Address - Fax:
Practice Address - Street 1:4321 CHURTON RD
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:NY
Practice Address - Zip Code:13476
Practice Address - Country:US
Practice Address - Phone:315-729-2742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228144164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161355896Medicare PIN