Provider Demographics
NPI:1235664202
Name:GEORGE, NATALIE
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:GEORGE
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 1:7111 A ST
Mailing Address - Street 2:#105
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4283
Mailing Address - Country:US
Mailing Address - Phone:402-601-0391
Mailing Address - Fax:
Practice Address - Street 1:7111 A ST
Practice Address - Street 2:#105
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4283
Practice Address - Country:US
Practice Address - Phone:402-601-0391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1058225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist