Provider Demographics
NPI:1164008306
Name:JAIN, NATALIE CHAVI (MPH, PA-S)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:CHAVI
Last Name:JAIN
Suffix:
Gender:F
Credentials:MPH, PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 N WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2335
Mailing Address - Country:US
Mailing Address - Phone:931-538-4466
Mailing Address - Fax:866-449-4618
Practice Address - Street 1:225 N WILLOW AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2335
Practice Address - Country:US
Practice Address - Phone:931-538-4466
Practice Address - Fax:866-449-4618
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant