Provider Demographics
NPI:1205823556
Name:LANTERNIER, NATALIE L (MD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:L
Last Name:LANTERNIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:L
Other - Last Name:RODRIQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3056 RIVER CROSSING COURT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:IA
Mailing Address - Zip Code:52327-4727
Mailing Address - Country:US
Mailing Address - Phone:319-467-8355
Mailing Address - Fax:319-467-8351
Practice Address - Street 1:3056 RIVER CROSSING COURT
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:IA
Practice Address - Zip Code:52327-4727
Practice Address - Country:US
Practice Address - Phone:319-467-8355
Practice Address - Fax:319-467-8351
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33880207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI20245OtherMEDICARE WP
IAP00418518OtherRR MEDICARE
IAP00687436OtherRR MEDICARE
IA1205823556Medicaid
IA1205823556Medicaid
IAI21102Medicare PIN
IAP00687436OtherRR MEDICARE
IAI20244Medicare PIN