Provider Demographics
NPI:1164853271
Name:NATALIE H. DANIELS, M.D., PLLC
Entity Type:Organization
Organization Name:NATALIE H. DANIELS, M.D., PLLC
Other - Org Name:BELLA PELLE DERMATOLOGY AND COSMETIC LASER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RATLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-494-2110
Mailing Address - Street 1:3594 SPRINGHURST BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-4141
Mailing Address - Country:US
Mailing Address - Phone:502-368-4133
Mailing Address - Fax:
Practice Address - Street 1:3594 SPRINGHURST BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-4141
Practice Address - Country:US
Practice Address - Phone:502-368-4133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-29
Last Update Date:2013-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41083207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty