Provider Demographics
NPI:1093578791
Name:SAND, NATOSHA KAY
Entity Type:Individual
Prefix:
First Name:NATOSHA
Middle Name:KAY
Last Name:SAND
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 1:25 AURORA DR
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:MT
Mailing Address - Zip Code:59230-2814
Mailing Address - Country:US
Mailing Address - Phone:406-263-1020
Mailing Address - Fax:
Practice Address - Street 1:25 AURORA DR
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:MT
Practice Address - Zip Code:59230-2814
Practice Address - Country:US
Practice Address - Phone:406-263-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program