Provider Demographics
NPI:1093467714
Name:PIKE, NATALIE MARIE
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:PIKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 S LINDEN RD STE B
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3440
Mailing Address - Country:US
Mailing Address - Phone:810-553-3025
Mailing Address - Fax:
Practice Address - Street 1:1321 S LINDEN RD STE B
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3440
Practice Address - Country:US
Practice Address - Phone:810-553-3025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist